Jill M Wilson, RRT, RCP

Primary specialty

Neonatal/Pediatric Registered Respiratory TherapistTaxonomy code 2279P3900X

License

15470 Issued in CA

Practice address

39400 Paseo Padre Pkwy
Fremont, CA 94538-2310

Phone

(510) 248-3747

NPI assigned

Sep 11, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jill M Balthazar Former name

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": "1599782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599782400000",
    "number": "1790390185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 CALIENTE AVE",
            "city": "LIVERMORE",
            "state": "CA",
            "postal_code": "945505355",
            "telephone_number": "925-413-2863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39400 PASEO PADRE PKWY",
            "city": "FREMONT",
            "state": "CA",
            "postal_code": "945382310",
            "telephone_number": "510-248-3747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JILL",
        "middle_name": "M",
        "credential": "RRT, RCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-11",
        "last_updated": "2020-09-11",
        "certification_date": "2020-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2279P3900X",
            "taxonomy_group": "",
            "desc": "Respiratory Therapist, Registered, Neonatal/Pediatrics",
            "state": "CA",
            "license": "15470",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JILL",
            "last_name": "BALTHAZAR",
            "middle_name": "M",
            "credential": "RRT, RCP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Whitney Williams, FNP
• Kevin Williamson
• Anjelica Rose Wilson
• Dana Wilson, CERTIFIED PEMF PROVI
• Fredrick Saul Wilson, DPM
• Kennedy Anice Wilson
• Leah Wilson
• Robin Wilson
• Shurea A. Wilson, MD
• Stephen A Wilson, M.D.

• Registered Respiratory Therapist in Fremont, CA
• Providers in Fremont, CA by specialty
• Registered Respiratory Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.