THEODORE B. WYATT JR. - NPI 1831028471 - In Home Supportive Care in Rancho Cucamonga, CA

Q: What is Theodore Wyatt's NPI number?

The NPI number for Theodore Wyatt is 1831028471. It was assigned to this individual provider in the NPPES registry on May 19, 2026.

Q: What is Theodore Wyatt's specialty?

The primary specialty registered for this NPI is In Home Supportive Care with taxonomy code 253Z00000X.

Q: When was this NPI record last updated?

The NPPES record for Theodore Wyatt was last updated on June 9, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 56 days 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.

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About Theodore B. Wyatt Jr. NPPES

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

THEODORE B. WYATT JR. (NPI 1831028471) is an individual in home supportive care provider in Rancho Cucamonga, California and active in the NPI registry since May 2026.

NPPES Registry Identity

NPI1831028471

Entity TypeIndividualMale

Primary Taxonomy253Z00000X

Provider Legal NameTHEODORE B. WYATT JR.

Location Address11175 AZUSA CT STE 110Rancho Cucamonga, CA 91730-4933

Mailing Address11175 Azusa Ct Ste 110Rancho Cucamonga, CA 91730-4933 · (503) 330-3708

Phone(503) 330-3708

Sole ProprietorYes

Enumeration DateMay 19, 2026

Last NPPES UpdateJune 9, 2026

NPPES CertifiedJune 9, 2026

✔ NPI 1831028471 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyIn Home Supportive CareAgencies

Taxonomy Code253Z00000X

Definition

An In Home Supportive Care Agency provides services in the patient's home with the goal of enabling the patient to remain at home. The services provided may include personal care services such as hands-on assistance with activities of daily living (ADLs), e.g., eating, bathing, dressing, and bladder and bowel requirements; homemaker services and instrumental activities of daily living (IADLs), e.g., taking medications, shopping for groceries, laundry, housekeeping, and companionship; and/or supervision or cuing so that a person can perform tasks themselves.

11175 AZUSA CT STE 110, Rancho Cucamonga, CA 91730

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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.

MARQUAN THOMAS

Community Health Worker