Mayra Wilson

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

AMFT108550 Issued in CA

Practice address

23115 Rider St
Perris, CA 92570-9723

Phone

(951) 686-8500

NPI assigned

Jul 11, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Olive Crest

  • Mental Illness Community Based Residential Treatment Facility
  • Perris, CA
  • NPI 1285288316
  NPD
• Mountain Counseling & Training, Inc.

  • Community Health Clinic/Center
  • Crestline, CA
  • NPI 1164739215
  NPD (past)

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

{
    "created_epoch": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1659723971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 E MOUNTAIN VIEW ST STE 100",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923112814",
            "telephone_number": "925-914-0575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23115 RIDER ST",
            "city": "PERRIS",
            "state": "CA",
            "postal_code": "925709723",
            "telephone_number": "951-686-8500"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "309 E Mountain View St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Barstow",
            "state": "CA",
            "postal_code": "923112814",
            "country_code": "US",
            "telephone_number": "925-914-0575 x1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MAYRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-07-11",
        "last_updated": "2021-06-09",
        "certification_date": "2021-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "AMFT108550",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thaddeus Wicki, LMFT
• Breeann Shanice Wilkinson
• Christina Annette Williams
• Jesse Anthony Williams III, L.V.N
• Antionese M Wilson
• Percy Lee Wilson Jr.
• Sierrah B Wilson, PA
• Tonya Lavette Wilson
• Jordyn Mikayla Windom
• Dennika Wines

• Marriage & Family Therapist in Perris, CA
• Providers in Perris, 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 Jun 9, 2021; 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.