Individual provider Active NPI

Mims Wilder, PHD, AMFT

  • Marriage & Family Therapist
  • Redding, CA
National Provider Identifier
1992348114
Registry record updated Jan 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
160687 Issued in CA
Practice address
1400 Oregon St
Redding, CA 96001-1620
Phone
(530) 768-1880
NPI assigned
Oct 21, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 160687 CA Primary

Addresses

Primary practice location

1400 Oregon St
Redding, CA 96001-1620

Mailing address

PO Box 12
Shasta Lake, CA 96019-0012
Phone (530) 232-0857

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
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
160687CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Legacy Center PastSince Jun 21, 2022 Accepting new patients
County of Shasta PastSince Oct 27, 2019 Accepting new patients
Children's Legacy Center Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1571616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768867200000",
    "number": "1992348114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12",
            "city": "SHASTA LAKE",
            "state": "CA",
            "postal_code": "960190012",
            "telephone_number": "530-232-0857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 OREGON ST",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960011620",
            "telephone_number": "530-768-1880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDER",
        "first_name": "MIMS",
        "name_prefix": "Dr.",
        "credential": "PHD, AMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-21",
        "last_updated": "2026-01-20",
        "certification_date": "2026-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "160687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redding, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2026; 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.