Laura Ann Wilson

Primary specialty

Clinical Genetics (M.D.) PhysicianTaxonomy code 207SG0201X

License

A165832 Issued in CA

Practice address

505 S Main St Ste 525
Orange, CA 92868-4553

Phone

(714) 456-5631

Fax

(714) 285-0389

NPI assigned

Mar 19, 2018

Last updated

Jun 6, 2024By the provider in NPPES

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lwilson1131097@direct.llu.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  Medicare reassignment NPD
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  • Neurological Surgery Physician
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  • NPI 1194775122
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Pediatrics Physician
  • Redlands, CA
  • NPI 1235189911
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Pediatrics Physician
  • Moreno Valley, CA
  • NPI 1285684605
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Pediatrics Physician
  • Highland, CA
  • NPI 1689624991
  NPD
• Faculty Physicians and Surgeons of Llusm

  • Orthopaedic Surgery Physician
  • Loma Linda, CA
  • NPI 1275582918
  NPD (past)

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

{
    "created_epoch": "1521417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717632000000",
    "number": "1841794567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33601 WINDJAMMER DR",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926294469",
            "telephone_number": "714-742-3245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S MAIN ST STE 525",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684553",
            "telephone_number": "714-456-5631",
            "fax_number": "714-285-0389"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11234 Anderson St",
            "address_purpose": "LOCATION",
            "city": "Loma Linda",
            "state": "CA",
            "postal_code": "923542804",
            "country_code": "US",
            "telephone_number": "909-558-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILSON",
        "first_name": "LAURA",
        "middle_name": "ANN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-03-19",
        "last_updated": "2024-06-06",
        "certification_date": "2024-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SG0201X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Genetics (M.D.)",
            "state": "CA",
            "license": "A165832",
            "primary": true
        },
        {
            "code": "207SG0207X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Medical Biochemical Genetics",
            "state": "CA",
            "license": "A165832",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Wilson
• Caroline Renee Wilson, DPT
• Emily Wilson
• Katlin T Wilson
• Kyla Wilson, LCSW
• Leah Marie Wilson, N.P.
• Lisa Marie Wilson, IMF/MFT
• Monet Alisha Wilson
• Monty C. Wilson, D.D.S.
• Natalie Wilson, N.P.

• Clinical Genetics (M.D.) Physician in Orange, CA
• Providers in Orange, CA by specialty
• Clinical Genetics (M.D.) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.