Active NPI
Stephanie Mabel Wilson
- Case Management Agency
- Long Beach, CA
National Provider Identifier
1427235019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- Practice address
- 415 West Ocean Blvd
Suite 100
Long Beach, CA 90802 - Phone
- (562) 491-5807
- Fax
- (562) 983-5747
- NPI assigned
- Jan 25, 2008
- 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 |
|---|---|---|---|---|
| Case Management Agency | 251B00000X | Primary |
Addresses
Primary practice location
415 West Ocean Blvd
Suite 100
Long Beach, CA 90802
Mailing address
9150 East Impreial Highway
Room P-31
Downey, CA 90242
Phone (562) 940-3694
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": "1201219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201219200000",
"number": "1427235019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9150 EAST IMPREIAL HIGHWAY",
"address_2": "ROOM P-31",
"city": "DOWNEY",
"state": "CA",
"postal_code": "90242",
"telephone_number": "562-940-3694",
"fax_number": "562-658-4725"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 WEST OCEAN BLVD",
"address_2": "SUITE 100",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "90802",
"telephone_number": "562-491-5807",
"fax_number": "562-983-5747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "STEPHANIE",
"middle_name": "MABEL",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-25",
"last_updated": "2008-01-25",
"status": "A"
},
"taxonomies": [
{
"code": "251B00000X",
"taxonomy_group": "",
"desc": "Case Management",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.