Charles Brandon Wilson, SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

1007 E Cooley Dr # 107
Colton, CA 92324-3901

Phone

(909) 388-2200

NPI assigned

Mar 15, 2023

Sex

Male

Sole proprietor

No

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

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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.

• Easy Speech Pathology, Inc.

  • Multi-Specialty Clinic/Center
  • Palm Desert, CA
  • NPI 1124434261
  Medicare reassignment NPD

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1740981711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6051 APPLECROSS DR",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925076493",
            "telephone_number": "562-715-8105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1007 E COOLEY DR # 107",
            "city": "COLTON",
            "state": "CA",
            "postal_code": "923243901",
            "telephone_number": "909-388-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "CHARLES",
        "middle_name": "BRANDON",
        "credential": "SLP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-15",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Winston James Williams
• Wylder Madison Williams
• Tempest Lapia Willoughby
• Wilshire Oncology Medical Group Inc
• Carleon Christos Wilson
• Clarence Carl Wilson, DBH, LPCC
• Jeffrey Randall Wirth, MFT
• Allison Lynn Wisniewski, D.O
• Kayla Marie Witcik, PA-C
• Alston Yip Wong

• Speech-Language Pathologist in Colton, CA
• Providers in Colton, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.