Andrenique Wilson

NPI 1265186027 · on the registry since 2022

Practice

Address: 12501 Chandler Blvd Ste 102
Valley Village, CA 91607
Phone: (424) 262-8039
Organisation at this address: Socal Medtrans
Shaid Hospice, Inc
Argo Home Health Inc
Kgv Easy Leasing Corp
Pro Psych Services Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 14

Registry record

Primary taxonomy: 106H00000X
106H00000X
Also registered as: 171M00000X
106H00000X
Licence states on file: CA
From the registry's licence fields, which are often incomplete.
Sex: Female
Record last updated: 2024-05-18

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California