Tasha Monique Wilson

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

955 W Center St Ste 12a
Manteca, CA 95337-7327

Phone

(209) 239-9600

NPI assigned

Oct 26, 2021

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

• Tasha Monique Williams Former name

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.

• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Manteca, CA
  • NPI 1134565740
  NPD (past)
• Aegis Treatment Centers, LLC

  • Methadone Clinic
  • Canoga Park, CA
  • NPI 1831601764
  NPD (past)

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1801550983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 W CENTER ST STE 12B",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953377327",
            "telephone_number": "209-407-1090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 W CENTER ST STE 12A",
            "city": "MANTECA",
            "state": "CA",
            "postal_code": "953377327",
            "telephone_number": "209-239-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "TASHA",
        "middle_name": "MONIQUE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TASHA",
            "last_name": "WILLIAMS",
            "middle_name": "MONIQUE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• William G. Low D.D.S. a Professional Dental Corporation
• Destiney Williams
• Wilson Family Counseling Services
• Kathleen Wilson-Parish
• Cynthia Wilson, MA, MFTI, AT
• Wirsa Wellness
• Karl Konrad Wolf, M.D.
• Kimberlee Ann Wong, PHARMD
• Rachel Chui-CHI Wong, PHARM.D.
• John B Woodbury, DO

• Addiction (Substance Use Disorder) Counselor in Manteca, CA
• Providers in Manteca, CA by specialty
• Addiction (Substance Use Disorder) Counselor in California

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