Mark Wilson, MOT OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

14125 Issued in CA

Practice address

2820 Roosevelt Road Ste 105
San Diego, CA 92106

Phone

(619) 607-4288

NPI assigned

Apr 3, 2014

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Children'S Occupational Therapy Services, Inc.

  • Early Intervention Provider Agency
  • San Diego, CA
  • NPI 1265738231
  NPD

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

{
    "created_epoch": "1396483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396483200000",
    "number": "1992123285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 EL RANCHO DRIVE",
            "city": "EL CAJON",
            "state": "CA",
            "postal_code": "92019",
            "telephone_number": "619-607-4288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2820 ROOSEVELT ROAD STE 105",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92106",
            "telephone_number": "619-607-4288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "MOT OTR/L",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-03",
        "last_updated": "2014-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "CA",
            "license": "14125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lani Kiku Hirota Wilson, O.D.
• Laurel Wilson
• Lindsay Elizabeth Wilson
• Lori Anne Wilson, L.AC.
• Marcella M. Wilson, MD
• Mark Alan Wilson
• Mary Malia Wilson, BCBA
• Matthew D Wilson, DPM
• Michael Cole Wilson, D.C.
• Monica Anne Wilson, RN, CNS

• Occupational Therapist in San Diego, CA
• Providers in San Diego, CA by specialty
• Occupational Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2014; 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.