Individual provider Active NPI

Joanne Wilson, DC

  • Chiropractor
  • San Ramon, CA
National Provider Identifier
1043104094
Registry record updated Jun 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC24666 Issued in CA
Practice address
2551 San Ramon Valley Blvd Ste 108
San Ramon, CA 94583-1661
Phone
(480) 322-1545
NPI assigned
Jun 4, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC24666 CA Primary

Addresses

Primary practice location

2551 San Ramon Valley Blvd Ste 108
San Ramon, CA 94583-1661

Mailing address

2551 San Ramon Valley Blvd Ste 108
San Ramon, CA 94583-1661
Phone (480) 322-1545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250620000811 CA Practitioner - Chiropractic 1456595768 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
DC24666CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Golden State Medical Center PC CurrentSince Jun 6, 2025 Accepting new patients

Locations

2551 San Ramon Valley Blvd
Ste 108
San Ramon, CA 94583
Phone (925) 838-4462

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1748995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748995200000",
    "number": "1043104094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2551 SAN RAMON VALLEY BLVD STE 108",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831661",
            "telephone_number": "480-322-1545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2551 SAN RAMON VALLEY BLVD STE 108",
            "city": "SAN RAMON",
            "state": "CA",
            "postal_code": "945831661",
            "telephone_number": "480-322-1545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOANNE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-04",
        "last_updated": "2025-06-04",
        "certification_date": "2025-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC24666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Ramon, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.