Kelly Wild, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

295056 Issued in CA

Practice address

4341 Piedmont Ave Ste 201
Oakland, CA 94611-4792

Phone

(510) 547-1630

NPI assigned

Sep 3, 2018

Sex

Female

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1535932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535932800000",
    "number": "1457833832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4341 PIEDMONT AVE STE 201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4341 PIEDMONT AVE STE 201",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946114792",
            "telephone_number": "510-547-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "KELLY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-03",
        "last_updated": "2018-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "295056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aviva S. Wilcox, PSYD
• Danny Reginald Wilcox
• Leona Joan Wilcox, OTR/L
• Robert David Wilcox Jr., M.S.
• Michaela Wilczynski, LCSW
• Lisa Wild, MFT
• Aurora Wilder
• Xena V Wildman-Hanlon
• Yolanda Denise Wilds, LVN
• Anne Wiley, RN

• Physical Therapist in Oakland, CA
• Providers in Oakland, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2018; 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.