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DR. THOMAS FREDERICK WYLIE PH.D. NPI 1336209774


NPI Information

NPI: 1336209774
Provider Name: DR. THOMAS FREDERICK WYLIE, PH.D.
Classification: Clinical Neuropsychologist - 103G00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
11573 LOS OSOS VALLEY RD
SUITE C
SAN LUIS OBISPO, CA
ZIP 93405
Phone: (805) 545-8951
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DR. Thomas Frederick Wylie, PH.D. is a clinical neuropsychologist in San Luis Obispo, CA. The provider is a clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems. DR. Thomas Frederick Wylie, PH.D. NPI is 1336209774. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

11573 LOS OSOS VALLEY RD
SUITE C
SAN LUIS OBISPO, CA
ZIP 93405-473
Phone: (805) 545-8951
Fax: (805) 545-8951

The NPI 1336209774 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Neuropsychological testing, interpretation, and report by psychologist or physician per hour (HCPCS:96118)

The enumeration date for this NPI number is 12/8/2006 and was last updated on 7/8/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1103G00000XClinical NeuropsychologistPSY12486CALIFORNIAYes
2103T00000XPsychologistPSY12486CALIFORNIAX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1R16058MEDICARE UPINCALIFORNIA
2CP12486MEDICARE ID-TYPE UNSPECIFIEDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.