A WILDWOOD RECOVERY IOP
NPI 1306323639
Clinic/Center - Rehabilitation, Substance Use Disorder in Thousand Oaks, CA

Active since July 19, 2018CLIA 05D2136286 · Waiver
166 N. MOORPARK RD, SUITE 304, THOUSAND OAKS, CA 91360(805) 497-1900(805) 497-1920 Get Directions Write a Review

NPPES record last updated: July 19, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About A Wildwood Recovery Iop NPPES

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

A WILDWOOD RECOVERY IOP (NPI 1306323639) is a healthcare organization registered as a rehabilitation, substance use disorder in Thousand Oaks, California and active in the NPI registry since July 2018. The organization holds a CLIA Waiver certificate valid through September 5, 2027 and lists Shannon Siaotong, Facility Administrator, as its authorized official.

NPPES Registry Identity

NPI1306323639
Entity TypeOrganization
Primary Taxonomy261QR0405X
Legal Business NameA WILDWOOD RECOVERY IOP
Location Address166 N. MOORPARK RD, SUITE 304Thousand Oaks, CA 91360
Mailing Address166 N. Moorpark Rd, Suite 304Thousand Oaks, CA 91360 · (805) 497-1900 · Fax (805) 497-1920
Fax(805) 497-1920
Organization SubpartYesParent: A Wildwood Recovery
Authorized OfficialShannon SiaotongFacility Administrator · (805) 493-5741
Enumeration DateJuly 19, 2018
NPI 1306323639 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Rehabilitation, Substance Use DisorderAmbulatory Health Care Facilities
Taxonomy Code261QR0405X
License Licensed in CA · 560040BP
166 N. MOORPARK RD, Thousand Oaks, CA 91360

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D2136286

A Wildwood Recovery · Thousand Oaks, CA
Active · expires Sep 5, 2027
CLIA Number05D2136286
Laboratory TypeOutpatient Substance Abus
Certificate Effective DateSeptember 6, 2025
Certificate Expiration DateSeptember 5, 2027
Laboratory DirectorThomas Walter, MD
Laboratory Phone(805) 497-1900
Laboratory LocationA Wildwood Recovery166 N Moorpark Rd Ste 304, Thousand Oaks, CA 91360
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

Dentist (General Practice)
166 N. MOORPARK RD, #204
THOUSAND OAKS, CA 91360

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is A Wildwood Recovery Iop's NPI number?

The NPI number for A Wildwood Recovery Iop is 1306323639. It was assigned to this organization in the NPPES registry on July 19, 2018.

Where is A Wildwood Recovery Iop located?

A Wildwood Recovery Iop is located at 166 N. Moorpark Rd Suite 304, Thousand Oaks, CA 91360. The listed phone number is (805) 497-1900.

What is A Wildwood Recovery Iop's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rehabilitation, Substance Use Disorder, with taxonomy code 261QR0405X.

Does A Wildwood Recovery Iop hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 05D2136286) is associated with this NPI, valid through September 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for A Wildwood Recovery Iop was last updated on July 19, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.