Active NPI
Elizabeth Ann Wilson, OTR
- Occupational Therapist
- Chula Vista, CA
National Provider Identifier
1407170095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 1519
- Practice address
- 525 Third Avenue
Chula Vista, CA 91910 - Phone
- (858) 505-5460
- Fax
- (858) 505-5479
- NPI assigned
- Mar 25, 2010
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 1519 | CA | Primary |
Addresses
Primary practice location
525 Third Avenue
Chula Vista, CA 91910
Mailing address
11682 Avenida Anacapa
El Cajon, CA 92019-5008
Phone (619) 670-0534
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 |
|---|---|---|---|
| 1519 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269475200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1269475200000",
"number": "1407170095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11682 AVENIDA ANACAPA",
"city": "EL CAJON",
"state": "CA",
"postal_code": "920195008",
"telephone_number": "619-670-0534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 THIRD AVENUE",
"city": "CHULA VISTA",
"state": "CA",
"postal_code": "91910",
"telephone_number": "858-505-5460",
"fax_number": "858-505-5479"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"name_prefix": "Ms.",
"credential": "OTR",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-03-25",
"last_updated": "2010-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "1519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chula Vista, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.