Juliana Suzanne Wilson, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA16242 Issued in CA

Practice address

7872 Walker St
La Palma, CA 90623-1796

Phone

(714) 527-8777

Fax

(714) 527-8990

NPI assigned

Sep 21, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 4

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1851587919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7872 WALKER ST",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231796",
            "telephone_number": "714-527-8777",
            "fax_number": "714-527-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7872 WALKER ST",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231796",
            "telephone_number": "714-527-8777",
            "fax_number": "714-527-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "JULIANA",
        "middle_name": "SUZANNE",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-09-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "PA16242",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "W12122A",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "W12122",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0061200",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0061190",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mya Michelle Wells
• Zhenntifer Wheeler
• Ryan Whyte, DPT, OTR/L, ATC
• Jacob Kai Williams
• Janqueray Williams
• Crystal Win
• Jaime Winn, PPS
• Josephine Chou Wong, OT
• Lydia Chin Wong, DO
• Winston C Wong, M.D.

• Medical Physician Assistant in La Palma, CA
• Providers in La Palma, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.