Debra Lee Wilson, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

838927 Issued in CA

Practice address

101 Jose Figueres Ave Ste 50
San Jose, CA 95116-2068

Phone

(408) 207-0560

Fax

(408) 708-7194

NPI assigned

Sep 16, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Locations

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.

• Momentum for Health

  • Community/Behavioral Health Agency
  • San Jose, CA
  • NPI 1477906410
  NPD

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1083220040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23062 EVERGREEN LN",
            "city": "LOS GATOS",
            "state": "CA",
            "postal_code": "950339219",
            "telephone_number": "408-402-1974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 JOSE FIGUERES AVE STE 50",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951162068",
            "telephone_number": "408-207-0560",
            "fax_number": "408-708-7194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "DEBRA",
        "middle_name": "LEE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2021-07-14",
        "certification_date": "2021-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "838927",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "838927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Anne Wills, B.A.
• Kate Russo Wilmot, PT
• Amy Wilson, BCBA
• Christine I.M. Wilson, NP
• Dawn Asheley Wilson
• Diana Christine Wilson, LCSW
• Ebonique Zanale Wilson
• Jackey Jett Wilson II
• Jada Joi Wilson
• James Dana Wilson, MHRS

• Registered Nurse in San Jose, CA
• Providers in San Jose, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2021; 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.