Olivia Jane Wilson, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA67272 Issued in CA

Practice address

4150 Regents Park Row Ste 230
La Jolla, CA 92037-1414

Phone

(858) 207-3117

Fax

(858) 240-4029

NPI assigned

Nov 12, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2025

Medicare assignment

May accept Medicare assignment

Group practices

Pacific Senior GroupGroup PAC ID 6406204270, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

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

• Pacific Senior Group

  • Internal Medicine Physician
  • Oceanside, CA
  • NPI 1154104461
  Medicare reassignment Care Compare group NPD
• Dansin, Inc

  • Specialist
  • Chula Vista, CA
  • NPI 1184892770
  Medicare reassignment NPD
• Kevin Yoo, M.D. Apc

  • Specialist
  • La Jolla, CA
  • NPI 1881785624
  Medicare reassignment NPD (past)
• Eye Surgery Ctr of So Calif a Med Group

  • Ambulatory Surgical Clinic/Center
  • Vista, CA
  • NPI 1619926755
  NPD

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

{
    "created_epoch": "1762905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775692800000",
    "number": "1962362020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "958 B AVE",
            "city": "CORONADO",
            "state": "CA",
            "postal_code": "921182606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 REGENTS PARK ROW STE 230",
            "city": "LA JOLLA",
            "state": "CA",
            "postal_code": "920371414",
            "telephone_number": "858-207-3117",
            "fax_number": "858-240-4029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "OLIVIA",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-12",
        "last_updated": "2026-04-09",
        "certification_date": "2026-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA67272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Paul Williams
• Sally Statham Williams, MD
• Sarah Lynn Williams, FNP
• Symphorosa M. Williams, M.D.
• Karen Therese Wilson, LCSW
• Rusty J Wilson, PA
• Erin Wiltchik, M.D.
• Windansea Recovery LLC
• Karen E Windoffer, FNP
• Tanya-Sue D. Winey, M.D.

• Physician Assistant in La Jolla, CA
• Providers in La Jolla, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2026; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.