Coral Lynn Wilson, RADT

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

4049 Miller Way
Sacramento, CA 95817-1332

Phone

(916) 451-9312

Fax

(916) 451-9312

NPI assigned

Apr 9, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1063919769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3716 FIELDING CIR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958264420",
            "telephone_number": "916-256-9801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4049 MILLER WAY",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958171332",
            "telephone_number": "916-451-9312",
            "fax_number": "916-451-9312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CORAL",
        "middle_name": "LYNN",
        "name_prefix": "Miss",
        "credential": "RADT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GATEWAY",
            "identifier": "C340020",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bridget Brown Wilson, M.S.W
• Bridget M. Wilson, NP
• Candy Jane Wilson
• Carolyn Deanna Wilson
• Christopher Jerome Wilson, MD
• Corey Wilson
• Craig Richard Wilson, CRNA
• Cynthia Wilson
• Daniel Lavelle Wilson
• David Lee Wilson Jr.

• Addiction (Substance Use Disorder) Counselor in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; 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.