Anita Lynn Wilson

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

License

1-00-0302 Issued in CA

Legal business name

ANITA LYNN WILSON

Practice address

4455 Murphy Canyon Rd
Suite 100
San Diego, CA 92123-4379

Phone

(619) 281-6067

NPI assigned

May 1, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Anita Lynn Wilson, PH.D., BCBA-D

Title

Executive and Clinical Director

Phone

(619) 281-6067

Specialties & licenses 1

Addresses

Other names 1

• ABA and VB Group Doing business as

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

{
    "created_epoch": "1335830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335830400000",
    "number": "1902164643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3245 UNIVERSITY AVE",
            "address_2": "SUITE 1-334",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921042009",
            "telephone_number": "619-281-6067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4455 MURPHY CANYON RD",
            "address_2": "SUITE 100",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921234379",
            "telephone_number": "619-281-6067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANITA LYNN WILSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-01",
        "last_updated": "2012-05-01",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "ANITA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "EXECUTIVE AND CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "619-281-6067",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D., BCBA-D"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Behavior Analyst",
            "state": "CA",
            "license": "1-00-0302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABA and VB Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Behavior Analyst in San Diego, CA
• Providers in San Diego, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2012; 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.