Michele Drisko Wilson, PHD

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP8495 Issued in CA

Practice address

4010 Barranca Parkway
Ste 220
Irvine, CA 92604-4711

Phone

(949) 857-6051

Fax

(949) 857-0941

NPI assigned

Jun 11, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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.

• Speech Pathology Associates

  • Speech-Language Pathologist
  • Irvine, CA
  • NPI 1710260179
  NPD (past)

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213142400000",
    "number": "1841450095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 BARRANCA PARKWAY",
            "address_2": "STE 220",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044711",
            "telephone_number": "949-857-6051",
            "fax_number": "949-857-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 BARRANCA PARKWAY",
            "address_2": "STE 220",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926044711",
            "telephone_number": "949-857-6051",
            "fax_number": "949-857-0941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHELE",
        "middle_name": "DRISKO",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "CA",
            "license": "AU1215",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "SP8495",
            "primary": true
        },
        {
            "code": "237600000X",
            "taxonomy_group": "",
            "desc": "Audiologist-Hearing Aid Fitter",
            "state": "CA",
            "license": "AU1215",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Willy Chua MD PA
• Alicia Wilson
• Alina Mae Wilson
• Elena Wilson, PMHNP-BC
• Jamie Wilson, OTR
• Monserrat Almeraz Wilson
• Nancy Lou Wilson, O.D.
• Randirose Wilson
• Rasha Wilson
• Tiffany D Wilson, M.D.

• Speech-Language Pathologist in Irvine, CA
• Providers in Irvine, 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 Jun 11, 2008; 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.