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General NPI Number Information
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NPI Number | 1699471482
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Entity Type | Organization
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Legal Business Name | WEA CA PC
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Dates
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Enumeration Date | 02/02/2023
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 969 E 12TH ST STE D
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City | LOS ANGELES
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State | CA
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Zip | 90021-2201
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Country | US
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Telephone | 408-341-9606
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Fax |
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Provider Business Mailing Address
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Address Line | 250 QUAIL RIDGE RD
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City | SCOTTS VALLEY
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State | CA
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Zip | 95066-4821
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | TYLER EVANS
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Credential | MD
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Telephone | 408-341-9606
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QR0800X
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Taxonomy Name | Recovery Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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