NPIMap

Organization Active NPI

Carolyn E. Wylie Center

  • Point of Service
  • Riverside, CA
National Provider Identifier
1972838670
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Point of ServiceTaxonomy code 305S00000X
License
60910 Issued in CA
Legal business name
CAROLYN E. WYLIE CENTER
Practice address
4164 Brockton Ave
Riverside, CA 92501-3400
Phone
(951) 683-5193
Fax
(951) 683-6019
NPI assigned
Oct 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

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

Authorized official

Name
Mr. Mickey Robinson
Title
Ceo
Phone
(951) 683-5193

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X 60910 CA Primary

Addresses

Primary practice location

4164 Brockton Ave
Riverside, CA 92501-3400

Mailing address

4164 Brockton Ave
Riverside, CA 92501-3400
Phone (951) 683-5193

National Provider Directory

National Provider Directory
Tax ID family
The Carolyn E Wylie Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4161 Brockton Ave
Riverside, CA 92501

NPI Registry JSON

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

{
    "created_epoch": "1255478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1972838670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4164 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013400",
            "telephone_number": "951-683-5193",
            "fax_number": "951-683-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4164 BROCKTON AVE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925013400",
            "telephone_number": "951-683-5193",
            "fax_number": "951-683-6019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAROLYN E. WYLIE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-14",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A",
        "authorized_official_last_name": "ROBINSON",
        "authorized_official_first_name": "MICKEY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "951-683-5193",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "CA",
            "license": "60910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.