Cristina Ambos Wilson

Primary specialty

Adult Development & Aging PsychologistTaxonomy code 103TA0700X

License

405801964 Issued in CA

Practice address

108 Holly Way
Pismo Beach, CA 93449-3221

Phone

(805) 904-6592

Fax

(805) 904-6593

NPI assigned

Dec 18, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1545091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545091200000",
    "number": "1649742479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 HOLLY WAY",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493221",
            "telephone_number": "805-904-6592",
            "fax_number": "805-904-6593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 HOLLY WAY",
            "city": "PISMO BEACH",
            "state": "CA",
            "postal_code": "934493221",
            "telephone_number": "805-904-6592",
            "fax_number": "805-904-6593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CRISTINA",
        "middle_name": "AMBOS",
        "name_prefix": "Miss",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-18",
        "last_updated": "2018-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "CA",
            "license": "405801964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lucille Amelia Whitaker, 11434
• Kathleen Wilde, RN
• Sarah Marie Willett, DPT
• Deirdre Betty Williams, DNP, FNP-BC
• Suzan Hillaire Williams, A.N.P.
• Jaclyn Woods, LMFT
• Carolyn Wright, PHD
• Stephanie Madalyn Yoder, MSN, FNP-BC
• Zoe Ann Zawalick, N.D.
• Clara Zhu, MD

• Adult Development & Aging Psychologist in Pismo Beach, CA
• Providers in Pismo Beach, CA by specialty
• Adult Development & Aging Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2018; 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.