Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Matthew James Wild, NURSEPRACTITIONER

Individual provider Psychiatric/Mental Health Nurse Practitioner · NPI 1295351757

Matthew James Wild, NURSEPRACTITIONER is a Nurse Practitioner in Los Angeles, California. Qualified in 2022, 4 years ago. Practices with Jwch Institute Inc, a 27-clinician group and accepts Medicare assignment. Licensed in California and New York.

Years since qualifying
4
Licensed in
CA, NY
In the registry since
2020
Specialties on file
4
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Practice location Address checks out

954 N Vermont Ave
Los Angeles, CA 90029-3529
Phone: (562) 867-7999
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatric/Mental Health Nurse Practitioner (primary) Taxonomy 363LP0808X · Licence 95024881 (CA)
Psychiatric/Mental Health Nurse Practitioner Taxonomy 363LP0808X · Licence 404299 (NY)
Registered Nurse Taxonomy 163W00000X · Licence 95325357 (CA)
Registered Nurse Taxonomy 163W00000X · Licence 794010 (NY)

Record details

NPI number1295351757
Entity typeIndividual (Type 1)
GenderMale
Credentials NURSEPRACTITIONER
Sole proprietorNo
NPI enumeratedJune 22, 2020
Last updated in NPPESAugust 30, 2023
Certification dateAugust 30, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Jwch Institute Inc — 27 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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