Carolyn Grace Wilson, B.S.

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3136 Issued in CA

Practice address

1200 El Camino Real
South San Francisco, CA 94080-3208

Phone

(650) 742-2000

NPI assigned

Jan 9, 2008

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Science

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Permanente Medical Group Inc

  • Internal Medicine Physician
  • Santa Clara, CA
  • NPI 1073606299
  NPD
• Permanente Medical Group, Inc

  • Clinical Medical Laboratory
  • San Jose, CA
  • NPI 1497971584
  NPD

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

{
    "created_epoch": "1199836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641168000000",
    "number": "1629253562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1171 FAIRMONT DR",
            "city": "SAN BRUNO",
            "state": "CA",
            "postal_code": "940662719",
            "telephone_number": "650-952-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 EL CAMINO REAL",
            "city": "SOUTH SAN FRANCISCO",
            "state": "CA",
            "postal_code": "940803208",
            "telephone_number": "650-742-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CAROLYN",
        "middle_name": "GRACE",
        "name_prefix": "Ms.",
        "credential": "B.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-09",
        "last_updated": "2022-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "3136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "1200 El Camino Real",
            "city": "South San Francisco",
            "state": "CA",
            "country_code": "US",
            "postal_code": "940803208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Colin Murray Willemsen, D.P.T.
• Brooke Alexander Williams, PHD
• Gabriella Nicole Williams
• Robert A. Williams, PH.D.
• James Donald Williamson
• Jed Wilson, PHARM.D.
• Nancy Wilson
• Leonie B Wohl, B PHARM
• Slawomir Wojtowicz-Praga, M.D.
• Aiden James Wondany

• Occupational Therapist in South San Francisco, CA
• Providers in South San Francisco, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2022; 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.