Traci Wilson LMFT Therapy LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

Legal business name

TRACI WILSON LMFT THERAPY LLC

Practice address

4305 Gesner St Ste 215
San Diego, CA 92117-6677

Phone

(916) 397-2443

NPI assigned

Jul 20, 2023

Organization subpart

No

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

Authorized official

Name

Traci WilsonNPI 1144938440

Title

Owner

Phone

(916) 397-2443

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Traci Wilson

  • Marriage & Family Therapist
  • San Diego, CA
  • NPI 1144938440
  NPD Authorized official

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

{
    "created_epoch": "1689811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689811200000",
    "number": "1639859093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3979 ALABAMA ST",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921042701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 GESNER ST STE 215",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921176677",
            "telephone_number": "916-397-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACI WILSON LMFT THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-20",
        "last_updated": "2023-07-20",
        "certification_date": "2023-07-20",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "TRACI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "916-397-2443"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2023; 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.