Jayson Wayne Paul Stilwell, NURSE PRACTITIONER

Primary specialty

Gerontology Registered NurseTaxonomy code 163WG0600X

License

95035735 Issued in CA

Practice address

3364 Beyer Blvd
San Ysidro, CA 92173-1322

Phone

(203) 675-6704

NPI assigned

Jun 24, 2025

Sex

Male

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1497643183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4315 3RD AVE APT 2310",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921031567",
            "telephone_number": "203-675-6704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3364 BEYER BLVD",
            "city": "SAN YSIDRO",
            "state": "CA",
            "postal_code": "921731322",
            "telephone_number": "203-675-6704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILWELL",
        "first_name": "JAYSON",
        "middle_name": "WAYNE PAUL",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-24",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "CA",
            "license": "95035735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Oliver M Solis, OD
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• Manuela Mercedes Soto-Mendez
• Aurelia Stephens, RN, CDE
• Elissa Kim Sullivan, MD
• Ramon Sy, MD
• Gregory A Talavera, M.D.
• Lo Fu Tan, MD
• Elizabeth Tec, PPS

• All providers in San Ysidro, CA
• Gerontology Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2025; 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.