THOMAS MATTHEW WYLIE
NPI 1114693546
Student in an Organized Health Care Education/Training Program in San Luis Obispo, CA

Q: What is Thomas Wylie's NPI number?

The NPI number for Thomas Wylie is 1114693546. It was assigned to this individual provider in the NPPES registry on August 17, 2021.

Q: What is Thomas Wylie's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Thomas Wylie was last updated on September 4, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 23 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 17, 2021

784 HIGH ST, SAN LUIS OBISPO, CA 93401(805) 540-6500(805) 540-6501 Get Directions Write a Review

NPPES record last updated: September 4, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 4, 2024, Aug 17, 2021 (2 updates tracked since 2021).

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About Thomas Matthew Wylie NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

THOMAS MATTHEW WYLIE (NPI 1114693546) is an individual student in an organized health care education/training program in San Luis Obispo, California and active in the NPI registry since August 2021.

NPPES Registry Identity

NPI1114693546

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameTHOMAS MATTHEW WYLIE

Location Address784 HIGH STSan Luis Obispo, CA 93401-5243

Mailing AddressPo Box 15408San Luis Obispo, CA 93406-5408 · (805) 540-6500 · Fax (805) 540-6501

Phone(805) 540-6500

Fax(805) 540-6501

Sole ProprietorNo

Enumeration DateAugust 17, 2021

Last NPPES UpdateSeptember 4, 20242 updates tracked since enumeration

NPPES CertifiedSeptember 4, 2024

✔ NPI 1114693546 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X

784 HIGH ST, San Luis Obispo, CA 93401

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAYMOND SAINT TAVAREZ

Counselor (Mental Health)