Individual provider · Type 1 NPI

Thomas Matthew Wylie

Student in an Organized Health Care Education/Training Program · San Luis Obispo, CA

NPI number 1114693546 Active

Practice location

784 High St
San Luis Obispo, CA 93401-5243

Call (805) 540-6500 Map

Fax (805) 540-6501

Mailing address

PO Box 15408
San Luis Obispo, CA 93406-5408

Specialties and licenses

TaxonomyCodeLicense
Case Manager/Care Coordinator 171M00000XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1114693546

Thomas Matthew Wylie's National Provider Identifier is 1114693546, issued on Aug 17, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in San Luis Obispo, CA. The record was last updated on Sep 4, 2024.