Active NPI
Ian Wilson
- Physical Therapist
- Templeton, CA
National Provider Identifier
1093558322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 306064
- Practice address
- 1051 Las Tablas Rd
Templeton, CA 93465-5603 - Phone
- (805) 434-4885
- Fax
- (805) 434-2864
- NPI assigned
- Jun 14, 2024
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 306064 | CA | Primary |
Addresses
Primary practice location
1051 Las Tablas Rd
Templeton, CA 93465-5603
Mailing address
1051 Las Tablas Rd
Templeton, CA 93465-5603
Phone (805) 434-4885
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
| License | State | Type | Specialty |
|---|---|---|---|
| 306064 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1718323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786924800000",
"number": "1093558322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1051 LAS TABLAS RD",
"city": "TEMPLETON",
"state": "CA",
"postal_code": "934655603",
"telephone_number": "805-434-4885",
"fax_number": "805-434-2864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1051 LAS TABLAS RD",
"city": "TEMPLETON",
"state": "CA",
"postal_code": "934655603",
"telephone_number": "805-434-4885",
"fax_number": "805-434-2864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "IAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-06-14",
"last_updated": "2026-08-17",
"certification_date": "2026-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "306064",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Templeton, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.