Seymoura Raychanel Wilson, CRT HAIR LOSS SPT

Primary specialty

Prosthetics Case ManagementTaxonomy code 1744P3200X

Practice address

3411 Crenshaw Blvd Apt 511
Los Angeles, CA 90016-4879

Phone

(323) 614-1465

NPI assigned

Jan 26, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

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": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611619200000",
    "number": "1134719800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1915 LEIGHTON AVE",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900621316",
            "telephone_number": "323-614-1465"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 CRENSHAW BLVD APT 511",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900164879",
            "telephone_number": "323-614-1465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SEYMOURA",
        "middle_name": "RAYCHANEL",
        "credential": "CRT HAIR LOSS SPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-01-26",
        "certification_date": "2021-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert M Wilson, M.D.
• Rodney Wilson
• Rujuta Bhatt Wilson, M.D.
• Samuel Beringer Wilson, M.S.W.
• Sedonni Simone Wilson, DDS
• Shadonna Jerria Wilson
• Sharlena Patriece Wilson, MD
• Shatira Wilson, MD
• Sonnee Wilson
• Sophia Rochelle Wilson, DNP, CRNA

• Prosthetics Case Management in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Prosthetics Case Management in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.