Michal Carolyn Wilson, PSY. D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

34175 Issued in CA

Practice address

21545 Centre Pointe Pkwy
Santa Clarita, CA 91350-2947

Phone

(661) 259-9439

NPI assigned

May 10, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708819200000",
    "number": "1912112335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21545 CENTRE POINTE PKWY",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913502947",
            "telephone_number": "661-259-9439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21545 CENTRE POINTE PKWY",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913502947",
            "telephone_number": "661-259-9439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MICHAL",
        "middle_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "PSY. D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-10",
        "last_updated": "2024-02-25",
        "certification_date": "2024-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CA",
            "license": "34175",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "8162",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "CA",
            "license": "WAIVER",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "34175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Destinie F Williams
• Elijah Williams
• Miguel Williams, M.D.
• Xavier Anthony Williams
• Jeffrey Scott Willis, D.C.
• Sydney Elizabeth Wilson
• Tamera Jeanne Wilson, PSY.D.
• Betzabe Sonaly Wintermute, SA-C
• Kristina Wittig, MD
• Yael Amy Wolf, MA, PPS

• Clinical Psychologist in Santa Clarita, CA
• Providers in Santa Clarita, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2024; 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.