Joy Ann Elaine Wilson, RDA

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

5066 Brooklawn PL
Riverside, CA 92504-1811

Phone

(951) 966-7374

NPI assigned

Nov 1, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Mrs. Joy Ann Elaine Wilson Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1698796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698796800000",
    "number": "1437922499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5066 BROOKLAWN PL",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925041811",
            "telephone_number": "951-966-7374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5066 BROOKLAWN PL",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925041811",
            "telephone_number": "951-966-7374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JOY ANN",
        "middle_name": "ELAINE",
        "credential": "RDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-11-01",
        "last_updated": "2023-11-01",
        "certification_date": "2023-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "126800000X",
            "taxonomy_group": "",
            "desc": "Dental Assistant",
            "state": "CA",
            "license": "RDA28952",
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JOY ANN",
            "last_name": "WILSON",
            "middle_name": "ELAINE",
            "prefix": "MRS.",
            "credential": "JOY ANN E MARTIN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Darren Wilson
• Delsa Tapia Wilson
• Elizabeth Wilson
• Jazmine Wilson
• Jennifer M Wilson
• Jyngee Wilson
• Kayla Marina Wilson, MS
• Lynne Marie Wilson, RN
• Mallory Wilson
• Mildred E. Wilson

• Community Health Worker in Riverside, CA
• Providers in Riverside, CA by specialty
• Community Health Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.