Healthcare Provider Details

I. General information

NPI: 1255236394
Provider Name (Legal Business Name): JAMES ALLEN WILEY JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6821 PLYMOUTH RD APT 21
STOCKTON CA
95207-2319
US

IV. Provider business mailing address

2730 SHANDELANDS DRIVE BUILDING 10
WALNUT CREEK CA
94598
US

V. Phone/Fax

Practice location:
  • Phone: 650-771-8112
  • Fax:
Mailing address:
  • Phone: 650-771-8112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: