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Individual
FREDERICK WYCOCO
Active
Individual
FREDERICK WYCOCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95010473
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
79465
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
95010473
CA
Other
Enumeration date
02/05/2019
Last updated
12/30/2025
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