Bernise Wilson

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

NP95003938 Issued in CA

Practice address

12900 Park Plaza Dr
Cerritos, CA 90703-9329

Phone

(866) 646-3553

NPI assigned

Aug 30, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525737600000",
    "number": "1194919456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 15921",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908150921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12900 PARK PLAZA DR",
            "city": "CERRITOS",
            "state": "CA",
            "postal_code": "907039329",
            "telephone_number": "866-646-3553"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1150 Baker St",
            "address_purpose": "LOCATION",
            "city": "Costa Mesa",
            "state": "CA",
            "postal_code": "926264111",
            "country_code": "US",
            "telephone_number": "562-881-8326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "BERNISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-30",
        "last_updated": "2018-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "NP95003938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janet William, NP
• Kristi Lauren Nicole Williams, CCC-SLP
• Robert Williams
• Sammie Williams, PSY.D.
• Ryley Wilmoth
• Benjamin Winarko, M.D.
• Andrew Winstead
• Winston Muditajaya, D.D.S., Inc.
• Jennifer Nicole Winter, ED.D.
• Brock Wirtz

• Family Nurse Practitioner in Cerritos, CA
• Providers in Cerritos, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.