Shadonna Jerria Wilson

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

3850 Crenshaw Blvd
Los Angeles, CA 90008-1821

Phone

(323) 751-3026

NPI assigned

Apr 16, 2019

Sex

Female

Sole proprietor

No

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

Practice roles

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.

• Southern California Health & Rehabilitation Program

  • Community/Behavioral Health Agency
  • Lynwood, CA
  • NPI 1467775221
  NPD (past)

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581292800000",
    "number": "1750944674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3850 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900081821",
            "telephone_number": "323-751-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3850 CRENSHAW BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900081821",
            "telephone_number": "323-751-3026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16410 Bloomfield Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Cerritos",
            "state": "CA",
            "postal_code": "907032144",
            "country_code": "US",
            "telephone_number": "562-760-4429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SHADONNA",
        "middle_name": "JERRIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-16",
        "last_updated": "2020-02-10",
        "certification_date": "2020-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rodney Wilson
• Rujuta Bhatt Wilson, M.D.
• Samuel Beringer Wilson, M.S.W.
• Sedonni Simone Wilson, DDS
• Seymoura Raychanel Wilson, CRT HAIR LOSS SPT
• Sharlena Patriece Wilson, MD
• Shatira Wilson, MD
• Sonnee Wilson
• Sophia Rochelle Wilson, DNP, CRNA
• Stephanie Yvonne Wilson

• Case Manager/Care Coordinator in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Case Manager/Care Coordinator in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2020; 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.