Tyler James Reynolds, IDHS
Military Health Care Provider, Independent Duty Medical Technicians in Petaluma, CA. Individual provider (NPI-1).
NPI number1972467223
StatusActive
Last updated in NPPESDec 11, 2025
Details
- NPI
- 1972467223
- Entity type
- Individual (NPI-1)
- Name
- Tyler James Reynolds
- Credential
- IDHS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 11, 2025
- Certification date
- Dec 11, 2025
- Last updated
- Dec 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1710I1003X | Military Health Care Provider, Independent Duty Medical Technicians | – | CA | Yes |
Practice location
599 Tomales RdPetaluma, CA 94952-5002
Phone 707-765-7200
Mailing address
599 Tomales RdPetaluma, CA 94952-5002
Phone 707-765-7200
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Independent Duty Medical Technicians providers in Petaluma, CA
Checking a whole list?
Paste up to 5,000 NPIs and download status, name, taxonomy, license and address for each one. Useful for credentialing, billing and pharmacy claim checks.