Active NPI
Julia Margaret Wilson
- Family Nurse Practitioner
- Costa Mesa, CA
National Provider Identifier
1528429149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 9016
- Practice address
- 55 Fair Dr
Costa Mesa, CA 92626-6520 - Phone
- (714) 668-6103
- Fax
- (714) 966-6306
- NPI assigned
- Mar 9, 2016
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Cardiac Rehabilitation Registered Nurse | 163WC3500X | 361377 | CA | |
| Family Nurse Practitioner | 363LF0000X | 9016 | CA | Primary |
Addresses
Primary practice location
55 Fair Dr
Costa Mesa, CA 92626-6520
Mailing address
22251 Eucalyptus LN
Lake Forest, CA 92630-3214
Phone (949) 583-1327
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9016 | CA | MD | Psychologist |
| 361377 | CA | MD | Cardiac Rehabilitation Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457481600000",
"number": "1528429149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22251 EUCALYPTUS LN",
"city": "LAKE FOREST",
"state": "CA",
"postal_code": "926303214",
"telephone_number": "949-583-1327",
"fax_number": "714-966-6306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FAIR DR",
"city": "COSTA MESA",
"state": "CA",
"postal_code": "926266520",
"telephone_number": "714-668-6103",
"fax_number": "714-966-6306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JULIA",
"middle_name": "MARGARET",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-09",
"last_updated": "2016-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "163WC3500X",
"taxonomy_group": "",
"desc": "Registered Nurse, Cardiac Rehabilitation",
"state": "CA",
"license": "361377",
"primary": false
},
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CA",
"license": "9016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Costa Mesa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.