Active NPI
Ann Wilson, PSY.D.
- Clinical Psychologist
- Castro Valley, CA
National Provider Identifier
1528312725
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 36477
- Practice address
- 15750 Foothill Blvd
Castro Valley, CA 94578-1012 - Phone
- (713) 300-0713
- NPI assigned
- Nov 9, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY22450 | CA | |
| Clinical Psychologist | 103TC0700X | 36477 | TX | Primary |
Addresses
Primary practice location
15750 Foothill Blvd
Castro Valley, CA 94578-1012
Mailing address
PO Box 173
Jerome, AZ 86331-0173
Phone (713) 300-0713
Other practice location 1
9911 Sterling Village Dr
Rosharon, TX 77583-0017
Phone (713) 300-0713
Other practice location 2
679 Verde Avenue
Jerome, AZ 86331-0173
Phone (713) 300-0173
Other practice location 3
2901 Wilcrest Dr # 434-1053
Houston, TX 77042-3399
Phone (713) 300-0713
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jul 1, 2024 through Jul 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY22450 | CA | MD | Clinical Psychologist |
| 36477 | TX | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1352419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1750204800000",
"number": "1528312725",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 173",
"city": "JEROME",
"state": "AZ",
"postal_code": "863310173",
"telephone_number": "713-300-0713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15750 FOOTHILL BLVD",
"city": "CASTRO VALLEY",
"state": "CA",
"postal_code": "945781012",
"telephone_number": "713-300-0713"
}
],
"practiceLocations": [
{
"address_1": "9911 Sterling Village Dr",
"address_purpose": "LOCATION",
"city": "Rosharon",
"state": "TX",
"postal_code": "775830017",
"country_code": "US",
"telephone_number": "713-300-0713",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "679 Verde Avenue",
"address_purpose": "LOCATION",
"city": "Jerome",
"state": "AZ",
"postal_code": "863310173",
"country_code": "US",
"telephone_number": "713-300-0173",
"fax_number": "832-583-0012",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2901 Wilcrest Dr # 434-1053",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "770423399",
"country_code": "US",
"telephone_number": "713-300-0713",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILSON",
"first_name": "ANN",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-11-09",
"last_updated": "2025-06-18",
"certification_date": "2025-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY22450",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "36477",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Castro Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.