1154587053 NPI number — MS. TOI LYNN WYLE MS, MFT, ERYT

Table of content: MS. TOI LYNN WYLE MS, MFT, ERYT (NPI 1154587053)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154587053 NPI number — MS. TOI LYNN WYLE MS, MFT, ERYT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WYLE
Provider First Name:
TOI LYNN
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS, MFT, ERYT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154587053
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/31/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 MC LELLAN DR
Provider Second Line Business Mailing Address:
#1051
Provider Business Mailing Address City Name:
SOUTH SAN FRANCISCO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94080-7520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
650-877-8071
Provider Business Mailing Address Fax Number:
650-877-8071

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
144 N CLAREMONT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN MATEO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94401-1924
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
415-235-5481
Provider Business Practice Location Address Fax Number:
650-877-8071
Provider Enumeration Date:
07/31/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  MFC33428 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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