CAROLYN MARIE WYATT (NPI# 1659699569) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659699569 |
| Entity Type | Individual |
| Full Name | CAROLYN MARIE WYATT |
| Credential | WHNP |
| Practice Address |
333 Laws Ave Ukiah CA 95482-6540 |
| Practice Telephone | 7074681010 |
| Practice Fax Number | 7074687958 |
| Mailing Telephone | 7074681010 |
| Mailing Fax Number | 7074687958 |
| Enumeration Date | 2010-05-17 |
| Last Update Date | 2010-05-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
19773 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316999840 | Carolyn Wyatt | Family Medicine | 8808 Centre Park Dr, Suite 206, Columbia, MD 21045-2126 | 2006-05-16 |
| 1558809525 | Carolyn Wyatt | Behavioral Analyst | 1706 E Broad St, Columbus, OH 43203 | 2017-02-09 |
| 1104095223 | Carolyn A Wyatt | Audiologist | 8218 Wisconsin Ave, Suite 106, Bethesda, MD 20814-3107 | 2008-02-22 |
| 1437139607 | Carolyn J. Wyatt | Psychologist | 814 S Washington St, Moscow, ID 83843-3049 | 2006-01-22 |
| Street Address |
333 LAWS AVE |
| City | UKIAH |
| State | CA |
| Zip Code | 95482-6540 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619970068 | Jorge Anibal Allende Jr. | Internal Medicine | 333 Laws Ave, Ukiah, CA 95482-6540 | 2005-05-31 |
| 1386262921 | Juliann Elizabeth Joseph | Advanced Practice Midwife | 333 Laws Ave, Ukiah, CA 95482-6540 | 2020-07-09 |
| 1164077038 | Neha Sharma | Dentist | 333 Laws Ave, Ukiah, CA 95482-6540 | 2019-08-07 |
| 1053890905 | Liliane Robison | Nurse Practitioner | 333 Laws Ave, Ukiah, CA 95482-6540 | 2018-08-11 |
| 1508356221 | Stuart Christian Mauger | Dentist | 333 Laws Ave, Ukiah, CA 95482-6540 | 2018-05-17 |
| 1831689025 | Kathryn Marie Manchester | Registered Nurse | 333 Laws Ave, Ukiah, CA 95482 | 2018-05-14 |
| 1457855942 | Phuc Cong Tran | Dentist | 333 Laws Ave, Ukiah, CA 95482 | 2018-03-20 |
| 1730600859 | Yesica Jaimes Mendoza | Health Educator | 333 Laws Ave, Ukiah, CA 95482-6540 | 2017-06-28 |
| 1629503727 | Terese O'connell | Dietitian, Registered | 333 Laws Ave, Ukiah, CA 95482-6540 | 2017-04-26 |
| 1821520487 | Connie L Austin | Dentist | 333 Laws Ave, Ukiah, CA 95482-6540 | 2017-03-31 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932726726 | Gloria Gonzalez Campise | Midwife | 205 W. Clay Street, Ukiah, CA 95482 | 2020-06-29 |
| 1083255095 | Mendocino Care Network | Internal Medicine | 1080 N State St, Ukiah, CA 95482 | 2019-10-01 |
| 1801383153 | Costco Wholesale Corporation | Pharmacy | 1275 Airport Park Blvd., Ukiah, CA 95482 | 2018-04-21 |
| 1922528256 | Ian David Winter | Case Manager/Care Coordinator | 1120 S. Dora St, Ukiah, CA 95482 | 2017-06-27 |
| 1568917938 | Rebecca Ann Dragomani | Nurse Practitioner | 260 Hospital Dr Ste 101, Ukiah, CA 95482 | 2016-08-16 |
| 1811362536 | Manzanita Services, Inc. | Community/Behavioral Health | 410 W. Jones St., Ukiah, CA 95482 | 2015-12-07 |
| 1689061061 | Pamela Mathias | Counselor | 367 East Gobbi Street, Suite E, Ukiah, CA 95482 | 2015-04-23 |
| 1275927030 | Jack David Segel | Counselor | 564 Dora St., Ste.d, Ukiah, CA 95482 | 2015-03-19 |
| 1689070211 | Mendocino County Youth Project | Clinic/Center | 347 Plum St, #b, Ukiah, CA 95482 | 2014-11-10 |
| 1346649951 | Ae Ran Ku | Dentist | 1096 South Dora Street, Ukiah, CA 95482 | 2014-08-19 |
| Find all providers in zip 95482 | ||||
| Taxonomy Code | 363LX0001X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Obstetrics & Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538428420 | Kathy Truelsen | Nurse Practitioner | 1050 N State St, Ukiah, CA 95482-3414 | 2012-05-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548819964 | Myra Sepulveda | Nurse Practitioner | 1700 Lombard St Ste 110, Oxnard, CA 93030-8288 | 2019-09-09 |
| 1639641699 | Zahra Jeylani Nur | Nurse Practitioner | 15101 Spectrum, Irvine, CA 92618-3426 | 2018-12-31 |
| 1518486125 | Patty Montoya | Nurse Practitioner | 1026 Felder St, Gardena, CA 90248-3348 | 2017-09-14 |
| 1902357817 | Alexandria Ludlow | Nurse Practitioner | 350 John Muir Pkwy Ste 205, Brentwood, CA 94513-5193 | 2016-10-17 |
| 1477922102 | Vanessa Domush | Nurse Practitioner | 845 E. Willow St, Signal Hill, CA 90755 | 2015-09-23 |
| 1174999015 | Kristina Hagopian | Nurse Practitioner | 8920 Wilshire Blvd Ste 525, Beverly Hills, CA 90211-1968 | 2015-08-14 |
| 1639553076 | Pacific Women's Healthcare Associates | Nurse Practitioner | 500 Superior Ave Ste 310, Newport Beach, CA 92663-3609 | 2015-07-15 |
| 1548655921 | Trudi J Petersen | Nurse Practitioner | 1700 Shattuck Ave # 75, Berkeley, CA 94709-3402 | 2015-04-01 |
| 1932590775 | Samah Shahzya Kureshi | Nurse Practitioner | 2619 Vanderbilt Ln Unit B, Redondo Beach, CA 90278-3318 | 2015-02-16 |
| 1346645801 | Norma Nix | Nurse Practitioner | 22423 Chase St, West Hills, CA 91304-3321 | 2014-10-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.