Active NPI
Juanita Wilson, AMFT
- Marriage & Family Therapist
- Corona, CA
National Provider Identifier
1851918627
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- Practice address
- 2275 S Main St Ste 201
Corona, CA 92882-5303 - Phone
- (951) 279-3222
- NPI assigned
- Jun 28, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | CA | Primary |
Addresses
Primary practice location
2275 S Main St Ste 201
Corona, CA 92882-5303
Mailing address
18350 Mount Langley St Ste 220
Fountain Valley, CA 92708-6912
Phone (714) 450-4118
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1593302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675728000000",
"number": "1851918627",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18350 MOUNT LANGLEY ST STE 220",
"city": "FOUNTAIN VALLEY",
"state": "CA",
"postal_code": "927086912",
"telephone_number": "714-450-4118"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2275 S MAIN ST STE 201",
"city": "CORONA",
"state": "CA",
"postal_code": "928825303",
"telephone_number": "951-279-3222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "JUANITA",
"name_prefix": "Mrs.",
"credential": "AMFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-06-28",
"last_updated": "2023-02-07",
"certification_date": "2023-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "CA",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corona, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.