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NPI Code Detail

MEDICARE: TYLER WADE BAKER-WILKINSON

MEDICARE: TYLER WADE BAKER-WILKINSON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist96824CA

General Provider Information

NPI Number : 1740660307
Entity Type Code : Individual
Provider Name (Legal Business Name) : TYLER WADE BAKER-WILKINSON
Provider Business Mailing Address
First Line : 2130 N VENTURA RD
Second Line :
City : OXNARD
State : CA
Zip : 93036-2258
Country : US
Telephone Number : 510-317-1444
Fax Number :
Provider Business Practice Location Address
First Line : 2130 N VENTURA RD
Second Line :
City : OXNARD
State : CA
Zip : 93036-2258
Country : US
Telephone Number : 510-317-1444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2015
Last Update Date : 01/07/2020

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Directions to “ TYLER WADE BAKER-WILKINSON ” Practice Location

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