Healthcare Provider Details
I. General information
NPI: 1093677221
Provider Name (Legal Business Name): WEA CA PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/25/2025
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
47915 OASIS ST
INDIO CA
92201-6950
US
IV. Provider business mailing address
47915 OASIS ST
INDIO CA
92201-6950
US
V. Phone/Fax
- Phone: 818-298-9444
- Fax: 866-811-0333
- Phone: 818-298-9444
- Fax: 866-811-0333
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103TB0200X |
| Taxonomy | Cognitive & Behavioral Psychologist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TYLER
B
EVANS
Title or Position: CEO
Credential:
Phone: 917-648-1068