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Search › California › 1041C0700X

Kelly Wilson

NPI 1528619160 · on the registry since 2019

Practice

Address
760 Mountain View St
Altadena, CA 91001
Phone
(626) 798-6793
Organisation at this address
Five Acres
Five Acres
Five Acres
Inferred from a shared address, not stated in the registry.
Clinicians at this address
139

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Also registered as
101YM0800X
390200000X
Licence states on file
CA
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2024-11-12

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