| Doctor Name: | WENDY WILEY |
| NPI Number: | 1720192487 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA |
| License Number: | PA11243 |
| Business Practice Address: | 3802 Main St Occidental, CA - 95465 |
| Business Phone Number: | 7078742444 |
| Business Fax Number: | 7078741664 |
| Mailing Address: | Po Box 1449, GUERNEVILLE |
| State: | CA |
| Postal Code: | 954461449 |
| Phone Number: | 7078695977 |
| Fax Number: | 7078695983 |
| NPI Enumeration Date: | 08/19/2006 |
| NPI Last Update Date: | 06/25/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA11243 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |