Individual provider Active NPI

Lou Ann Wiles, MFT

  • Marriage & Family Therapist
  • Fair Oaks, CA
National Provider Identifier
1902963390
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC32660 Issued in CA
Practice address
4096 Bridge St
Suite 7
Fair Oaks, CA 95628-7163
Phone
(916) 966-1356
Fax
(916) 966-1356
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC32660 CA Primary

Addresses

Primary practice location

4096 Bridge St
Suite 7
Fair Oaks, CA 95628-7163

Mailing address

4096 Bridge St
Suite 7
Fair Oaks, CA 95628-7163
Phone (916) 966-1356

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC32660CAMDMarriage & Family Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902963390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4096 BRIDGE ST",
            "address_2": "SUITE 7",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287163",
            "telephone_number": "916-966-1356",
            "fax_number": "916-966-1356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4096 BRIDGE ST",
            "address_2": "SUITE 7",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287163",
            "telephone_number": "916-966-1356",
            "fax_number": "916-966-1356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILES",
        "first_name": "LOU",
        "middle_name": "ANN",
        "credential": "MFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC32660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Oaks, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.