Individual provider Active NPI

Patricia Ann Wilson, LMFT

  • Marriage & Family Therapist
  • San Diego, CA
National Provider Identifier
1043593742
Registry record updated Sep 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC 41145 Issued in CA
Practice address
877 Island Ave
207
San Diego, CA 92101-7116
Phone
(619) 229-8445
NPI assigned
Sep 20, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC 41145 CA Primary

Addresses

Primary practice location

877 Island Ave
207
San Diego, CA 92101-7116

Mailing address

877 Island Ave
207
San Diego, CA 92101-7116
Phone (619) 229-8445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC 41145CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1316476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316476800000",
    "number": "1043593742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "877 ISLAND AVE",
            "address_2": "207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017116",
            "telephone_number": "619-229-8445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "877 ISLAND AVE",
            "address_2": "207",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921017116",
            "telephone_number": "619-229-8445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "PATRICIA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-20",
        "last_updated": "2011-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC 41145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.