Active NPI
Myra Wilson, IBCLC
- Lactation Consultant (Non-RN)
- Corona, CA
National Provider Identifier
1407797152
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Lactation Consultant (Non-RN)
- Practice address
- 802 Kingsgate Dr
Corona, CA 92882-6864 - Phone
- (951) 223-6966
- NPI assigned
- Apr 4, 2026
- 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 |
|---|---|---|---|---|
| Lactation Consultant (Non-RN) | 174N00000X | Primary |
Addresses
Primary practice location
802 Kingsgate Dr
Corona, CA 92882-6864
Mailing address
802 Kingsgate Dr
Corona, CA 92882-6864
Phone (951) 223-6966
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1775260800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1775260800000",
"number": "1407797152",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "802 KINGSGATE DR",
"city": "CORONA",
"state": "CA",
"postal_code": "928826864",
"telephone_number": "951-223-6966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "802 KINGSGATE DR",
"city": "CORONA",
"state": "CA",
"postal_code": "928826864",
"telephone_number": "951-223-6966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "MYRA",
"credential": "IBCLC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2026-04-04",
"last_updated": "2026-04-04",
"certification_date": "2026-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "174N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Lactation Consultant, Non-RN",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.