Individual provider Active NPI

Jessica Wilson, FNP-BC

  • Family Nurse Practitioner
  • San Francisco, CA
National Provider Identifier
1275189110
Registry record updated Mar 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
95011858 Issued in CA
Practice address
2 Embarcadero Ctr Lbby Level
San Francisco, CA 94111-3823
Phone
(888) 663-6331
Fax
(415) 252-7176
NPI assigned
Aug 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 95011858 CA Primary

Addresses

Primary practice location

2 Embarcadero Ctr Lbby Level
San Francisco, CA 94111-3823

Mailing address

1 Embarcadero Ctr Ste 1900
San Francisco, CA 94111-3723
Phone (415) 658-6791

Other practice location 1

4060 Fairmount Ave
San Diego, CA 92105-1608
Phone (619) 779-7900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250219003064 CA Practitioner - Nurse Practitioner 1658702782 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
95011858CAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
La Maestra Family Clinic, Inc. CurrentSince Dec 15, 2024 Accepting new patients
La Maestra Family Clinic, Inc. CurrentSince Dec 15, 2024 Accepting new patients
La Maestra Family Clinic, Inc. Current Accepting new patients
La Maestra Family Clinic Past Accepting new patients
La Maestra Family Clinic Inc. Past Accepting new patients

Locations

1032 Broadway
El Cajon, CA 92021
Phone 6192804213 ext. 3176

165 S 1st St
El Cajon, CA 92019
Phone (619) 312-0347

217 Highland Ave
National City, CA 91950
Phone (619) 280-4213

4171 Fairmount Ave
San Diego, CA 92105
Phone (619) 280-4213

4074 Fairmount Ave
San Diego, CA 92105
Phone (619) 284-1141

4060 Fairmount Ave
San Diego, CA 92105
Phone (619) 255-9155

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • Direct secure messaging: jessica.wilson.p1@direct.lamaestra.nextgenshare.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741910400000",
    "number": "1275189110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 EMBARCADERO CTR STE 1900",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113723",
            "telephone_number": "415-658-6791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 EMBARCADERO CTR LBBY LEVEL",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941113823",
            "telephone_number": "888-663-6331",
            "fax_number": "415-252-7176"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4060 Fairmount Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921051608",
            "country_code": "US",
            "telephone_number": "619-779-7900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JESSICA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2025-03-14",
        "certification_date": "2025-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "95011858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

Verify at the official NPI Registry.