Jennifer Lynn Wilson

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

109333 Issued in CA

Practice address

107 Figueroa St Ste 6
Ventura, CA 93001-2756

Phone

(805) 707-4625

Fax

(805) 232-3224

NPI assigned

Dec 30, 2019

Sex

Female

Sole proprietor

Yes

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

Enrolled in CA, WA2 enrollments

Opted out of Medicare

Yes, effective May 28, 2026 through May 28, 2028

Enrollment records 2

Specialty

Marriage and Family Therapist

Education

Other, 2018

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Bridges Family Therapy Inc

  • Marriage & Family Therapist
  • Modesto, CA
  • NPI 1609436534
  Medicare reassignment NPD
• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Marriage & Family Therapist

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  Marriage & Family Therapist, WA

  Medicare reassignment NPD

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

{
    "created_epoch": "1577664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700611200000",
    "number": "1366081986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 MARICOPA HWY STE 265",
            "city": "OJAI",
            "state": "CA",
            "postal_code": "930233161",
            "telephone_number": "805-707-4625",
            "fax_number": "805-232-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 FIGUEROA ST STE 6",
            "city": "VENTURA",
            "state": "CA",
            "postal_code": "930012756",
            "telephone_number": "805-707-4625",
            "fax_number": "805-232-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-30",
        "last_updated": "2023-11-22",
        "certification_date": "2023-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "109333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Williamson
• Devena Wilson-Taylor
• Christian Wilson, O.D.
• Edward Wilson, DO
• Jeffrey David Wilson, MPT
• Jeremy Wilson, PHD, BCBA-D
• Larin Wilson, M.A., CCC-SLP
• Lindsey Wilson, BCBA
• Milytza Estefania Wilson
• Ralph Ray Wilson, D.C.

• Marriage & Family Therapist in Ventura, CA
• Providers in Ventura, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.