SALLY WILSON (NPI# 1255673893) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255673893 |
| Entity Type | Individual |
| Full Name | SALLY WILSON |
| Credential | FNP |
| Practice Address |
4456 Dawes Ave Culver City CA 90230 |
| Mailing Address |
4456 Dawes Ave Culver City CA 90230-5124 |
| Practice Telephone | 3103194503 |
| Mailing Telephone | 3103194503 |
| Enumeration Date | 2013-03-21 |
| Last Update Date | 2013-03-21 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163WW0101X |
Registered Nurse Specialization: Women's Health Care, Ambulatory |
514467 | CA | Nursing Service Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
13414 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194890285 | Sally L. Wilson | Psychologist | 30500 Fairmount Blvd Ste 9, Pepper Pike, OH 44124-4802 | 2006-11-22 |
| 1093354847 | Sally Wilson | Pharmacist | 7450 Cypress Gardens Blvd, Winter Haven, FL 33884-6200 | 2019-12-26 |
| 1083269492 | Sally Sobon Wilson | Nurse Practitioner | 213 West Ave, Ocean City, NJ 08226-4131 | 2019-08-03 |
| 1154813046 | Sally Wilson | Speech-Language Pathologist | 125 Buena Vista Cir, South Hill, VA 23970-1431 | 2018-06-05 |
| 1013343763 | Sally Wilson | Social Worker | 3011 Akron Rd, Wooster, OH 44691-7904 | 2013-09-25 |
| 1407122807 | Sally R Wilson | Registered Nurse | 6440 Nieman Rd, Shawnee, KS 66203-3326 | 2012-03-29 |
| 1316196058 | Sally W Wilson | Counselor | 225 S Church St, West Chester, PA 19382-3386 | 2008-09-18 |
| 1992711964 | Sally King Wilson | Family Medicine | 121 S Cochran Ave, Suite C, Charlotte, MI 48813-1568 | 2006-07-31 |
| Street Address |
4456 DAWES AVE |
| City | CULVER CITY |
| State | CA |
| Zip Code | 90230 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558822064 | Smilemax Dental Center | Dentist | 10814 Jefferson Blvd. #g, Culver City, CA 90230 | 2019-03-27 |
| 1023532595 | Mary Alice Haye | Marriage & Family Therapist | 550 S. Vermont Ave., 7th Floor, 700, Los Angeles, CA 90230 | 2017-07-27 |
| 1902342074 | Dorene Lehavi | Social Worker | 5106 S Slauson Ave, Suite 192, Los Angeles, CA 90230 | 2017-01-13 |
| 1548634553 | Kimberly Henck | Speech-Language Pathologist | 607 Bristol Pkwy, Ste 105, Culver City, CA 90230 | 2015-11-15 |
| 1346628898 | Stephan Sepernia | Marriage & Family Therapist | 5601 W. Slavson Ave. #192, Culver City, CA 90230 | 2015-05-15 |
| 1558749291 | Sean Steven Mcknee | Chiropractor | 5839 Green Valley Cir Ste 102, Culver City, CA 90230 | 2015-05-14 |
| 1821484841 | Jasmine Lee | Family Medicine | 6000 Sepulveda Blvd Ste E10, Culver City, CA 90230 | 2015-04-07 |
| 1043609191 | Carrie Mays | Counselor | 4760 Sepulvda Blvd., Culver City, CA 90230 | 2015-01-13 |
| 1457759375 | Monquenta Felicia Young | Case Manager/Care Coordinator | 666 Green Valley Circle, Culver City, CA 90230 | 2014-12-09 |
| 1972902724 | Shana Chan Pope | Marriage & Family Therapist | 11949 Jefferson Blvd #106, Culver City, CA 90230 | 2014-08-18 |
| Find all providers in zip 90230 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659919223 | Sazia Malek | Nurse Practitioner | 3900 Bentley Ave, Culver City, CA 90232-3906 | 2019-12-14 |
| 1194375303 | Anthonia Chidimma Anuluoha | Nurse Practitioner | 3118 Reid Ave, Culver City, CA 90232-7413 | 2019-09-19 |
| 1699119636 | Keiko Kanzaki | Nurse Practitioner | 10850 Stever St, Culver City, CA 90230-5464 | 2013-04-22 |
| 1568716835 | Merlyn Ann Grossman | Nurse Practitioner | 9632 Lucerne Ave Apt 1, Culver City, CA 90232-2938 | 2012-11-07 |
| 1255608741 | Jamie Hidalgo Armendariz | Nurse Practitioner | 4074 Van Buren Pl., Culver City, CA 90232-2828 | 2011-11-28 |
| 1013375211 | Jane Ogechi Agu | Nurse Practitioner | 9808 Venice Blvd, Culver City, CA 90232 | 2016-02-02 |
| 1225479660 | Nidhi Kumar Madana | Nurse Practitioner | 3828 Delmas Ter, Culver City, CA 90232-2713 | 2013-07-15 |
| 1699953471 | Patricia Ann Garrity | Nurse Practitioner | 9808 Venice Blvd., Suite 700, Culver City, CA 90232 | 2008-02-05 |
| 1407926546 | Melissa Paras Monaghan | Nurse Practitioner | 4760 Sepulveda Blvd, Culver City, CA 90230-4820 | 2006-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962003640 | Samira Kadri | Nurse Practitioner | 431 S Burnside Ave Apt 3g, Los Angeles, CA 90036-5343 | 2020-11-08 |
| 1801497706 | Ana Maria Cajigas De Jesus | Nurse Practitioner | 313 S Velva Pl, Anaheim, CA 92804-2647 | 2020-11-06 |
| 1609477421 | Taylor Mcknight | Nurse Practitioner | 5073 Oxford Dr, Cypress, CA 90630-3653 | 2020-11-06 |
| 1619578465 | Roslyn Dykes-barrow | Nurse Practitioner | 17631 Mulberry Dr, Carson, CA 90746-7403 | 2020-11-06 |
| 1861093601 | Philana P Mcdonald | Nurse Practitioner | 183 Stonebridge Ln, Paso Robles, CA 93446-1926 | 2020-11-06 |
| 1386245264 | Annie Parikh | Nurse Practitioner | 11675 Lambert Ave, El Monte, CA 91732-1955 | 2020-11-05 |
| 1073114096 | Blanca De Jesus Serrano | Nurse Practitioner | 18144 Outer Hwy 18 Ste 200, Apple Valley, CA 92307-2212 | 2020-11-05 |
| 1578164166 | Aimon Sangwanpanich | Nurse Practitioner | 8520 Shirley Ave, Northridge, CA 91324-4149 | 2020-11-02 |
| 1043810757 | Casie Lee Mcguire | Nurse Practitioner | 1826 Rainbow Terrace Ln, Montebello, CA 90640-1953 | 2020-10-30 |
| 1295335099 | Jail Lopez | Nurse Practitioner | 3171 Lynwood Rd, Lynwood, CA 90262-4118 | 2020-10-29 |
| Find all providers with the same taxonomy | ||||
| City | CULVER CITY |
| Zip Code | 90230 |
Please comment or provide details below to improve the information on SALLY WILSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.