Individual provider Active NPI

Jeffrey Matthew Wilson, NP

  • Psychiatric/Mental Health Nurse Practitioner
  • Santa Ana, CA
National Provider Identifier
1801185814
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
95033035 Issued in CA
Practice address
5 Hutton Centre Dr Ste 950
Santa Ana, CA 92707-8714
Phone
(855) 434-7763
NPI assigned
Mar 30, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 95033035 CA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 95033035 CA Primary

Addresses

Primary practice location

5 Hutton Centre Dr Ste 950
Santa Ana, CA 92707-8714

Mailing address

7750 Via Francesco Unit 2
San Diego, CA 92129-5149
Phone (562) 682-5069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250625003335 CA Practitioner - Nurse Practitioner 0244742153 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

12618 Picrus St
San Diego, CA 92129-4119

5 Hutton Centre Dr
Suite 950
Santa Ana, CA 92707-8786

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Senior Doc Integrated Med, PC CurrentSince Apr 7, 2026 Accepting new patients
J M Geiss DO Apc CurrentSince May 12, 2025 Accepting new patients

Locations

520 Superior Ave
Ste 255
Newport Beach, CA 92663
Phone (949) 720-9266

5 Hutton Centre Dr
Ste 950
Santa Ana, CA 92707
Phone (855) 434-7663

28650 Newhall Ranch Rd
Santa Clarita, CA 91355
Phone (661) 347-0051

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1301443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1749427200000",
    "number": "1801185814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7750 VIA FRANCESCO UNIT 2",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921295149",
            "telephone_number": "562-682-5069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 HUTTON CENTRE DR STE 950",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927078714",
            "telephone_number": "855-434-7763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JEFFREY",
        "middle_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-03-30",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95033035",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95033035",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Ana, CA

Sources for this page

Verify at the official NPI Registry.