Active NPI
Sierrah B Wilson, PA
- Physician Assistant
- Perris, CA
National Provider Identifier
1093537540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA65253
- Practice address
- 215 W Fourth St
Perris, CA 92570 - Phone
- (951) 943-4751
- NPI assigned
- Oct 28, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA65253 | CA | Primary |
Addresses
Primary practice location
215 W Fourth St
Perris, CA 92570
Mailing address
25965 Reed Way
Loma Linda, CA 92354-3888
Phone (714) 931-5900
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA65253 | CA | MD | Physician Assistant |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/FGECDD/Endpoint/FGECDD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730073600000",
"number": "1093537540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25965 REED WAY",
"city": "LOMA LINDA",
"state": "CA",
"postal_code": "923543888",
"telephone_number": "714-931-5900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "215 W FOURTH ST",
"city": "PERRIS",
"state": "CA",
"postal_code": "92570",
"telephone_number": "951-943-4751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "SIERRAH",
"middle_name": "B",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-28",
"last_updated": "2024-10-28",
"certification_date": "2024-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "PA65253",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perris, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.