Individual provider Active NPI

Amaya Wilson, PA-C

  • Physician Assistant
  • Brea, CA
National Provider Identifier
1609727114
Registry record updated Mar 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA67936 Issued in CA
Practice address
380 W Central Ave Ste 310
Brea, CA 92821-3066
Phone
(657) 286-2670
Fax
(657) 286-2668
NPI assigned
Feb 9, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA67936 CA Primary

Addresses

Primary practice location

380 W Central Ave Ste 310
Brea, CA 92821-3066

Mailing address

380 W Central Ave Ste 310
Brea, CA 92821-3066
Phone (657) 286-2670

Other practice location 1

5020 Campus Dr Ste 200
Newport Beach, CA 92660-2111
Phone (949) 773-4135

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

LicenseStateTypeSpecialty
PA67936CAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1770595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774569600000",
    "number": "1609727114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "380 W CENTRAL AVE STE 310",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213066",
            "telephone_number": "657-286-2670",
            "fax_number": "657-286-2668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 W CENTRAL AVE STE 310",
            "city": "BREA",
            "state": "CA",
            "postal_code": "928213066",
            "telephone_number": "657-286-2670",
            "fax_number": "657-286-2668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5020 Campus Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Newport Beach",
            "state": "CA",
            "postal_code": "926602111",
            "country_code": "US",
            "telephone_number": "949-773-4135",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "AMAYA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-02-09",
        "last_updated": "2026-03-27",
        "certification_date": "2026-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA67936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brea, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2026; 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.