JENNIFER WILSON (NPI# 1902116866) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902116866 |
| Entity Type | Individual |
| Full Name | JENNIFER WILSON |
| Credential | PA-C |
| Practice Address |
520 Superior Ave Ste 360 Newport Beach CA 92663-3668 |
| Mailing Address |
Po Box 2493 Newport Beach CA 92659-1493 |
| Practice Telephone | 9496441025 |
| Practice Fax Number | 9496447852 |
| Mailing Telephone | 6572413600 |
| Mailing Fax Number | 6572417708 |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2018-05-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA21150 | CA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | MEDICARE | EE932Y | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770112013 | Jennifer Rockell Wilson | Case Manager/Care Coordinator | 450 S Venoy Rd, Westland, MI 48186-7805 | 2020-04-08 |
| 1023577665 | Jennifer Marie Wilson | Social Worker | 9660 Bend Dr, Jenison, MI 49428-9525 | 2019-03-13 |
| 1720545049 | Jennifer M Wilson | Registered Nurse | 17 Ridge Ave, Spring Valley, NY 10977-5407 | 2019-02-22 |
| 1528533726 | Jennifer S. Wilson | Specialist/Technologist | 216 Cody Ct, Clarksville, TN 37043-5897 | 2018-10-04 |
| 1750881488 | Jennifer Michele Wilson | Licensed Vocational Nurse | 20606 N Interstate 35, West, TX 76691-1812 | 2018-02-19 |
| 1942725700 | Jennifer Lynnette Wilson | Physician Assistant | 282 Equestrian Way, Raeford, NC 28376-7721 | 2017-08-13 |
| 1548782543 | Jennifer Wilson | Nurse Practitioner | 4665 W Atlantic Ave Ste B, Delray Beach, FL 33445-3800 | 2017-07-11 |
| 1770012775 | Jennifer Wilson | Registered Nurse | 3902 Henderson Blvd Ste 202, Tampa, FL 33629-5034 | 2017-06-05 |
| 1174069694 | Jennifer Wilson | Behavior Technician | 2014 Quail Run Dr Ne, Albuquerque, NM 87122-1100 | 2017-01-07 |
| 1033579396 | Jennifer Wilson | Nurse Practitioner | 10001 S Eastern Ave Ste 407, Henderson, NV 89052-3908 | 2016-03-01 |
| Street Address |
520 SUPERIOR AVE STE 360 |
| City | NEWPORT BEACH |
| State | CA |
| Zip Code | 92663-3668 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316983448 | Kathleen Boos | Family Medicine | 520 Superior Ave Ste 360, Newport Beach, CA 92663-3668 | 2006-06-20 |
| 1093147712 | Crystal Huynh | Physician Assistant | 520 Superior Ave Ste 360, Newport Beach, CA 92663-3668 | 2013-08-05 |
| 1477828820 | Sarin Prakobwanakit | Family Medicine | 520 Superior Ave Ste 360, Newport Beach, CA 92663-3668 | 2012-03-19 |
| 1275845125 | Carol M Tunney | Family Medicine | 520 Superior Ave Ste 360, Newport Beach, CA 92663-3668 | 2010-07-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851905483 | Oasis Anesthesia, Surgical and Medical Group, Inc | Anesthesiology | 496 Old Newpor Blvd., Suite 2, Newport Beach, CA 92663 | 2020-09-01 |
| 1699232801 | Megan Gregor | Surgery | One Hoag Dr., Bldg 41, Ste 122, Newport Beach, CA 92663 | 2019-02-24 |
| 1831621382 | Narges Maududi | Social Worker | 1965 Sherrington Place, K111, Newport Beach, CA 92663 | 2017-04-03 |
| 1225495153 | Mitchelle Giorgi | Physical Therapist | 351 Hospital Road, Suite 007, Newport Beach, CA 92663 | 2016-01-22 |
| 1043620057 | Leslie Mccormack | Speech-Language Pathologist | 270 Cagney Lane #101, Newport Beach, CA 92663 | 2014-04-29 |
| 1265867162 | Hotel California By The Sea, LLC | Substance Abuse Rehabilitation Facility | 4504 Seashore Drive, Newport Beach, CA 92663 | 2013-09-10 |
| 1538504733 | Shawn Zardouz | Psychiatry & Neurology | 3900 W Coast Hwy Ste 390, Newport Beach, CA 92663 | 2013-05-02 |
| 1326330119 | Denise Fortenberry Fortenberry-gratias | Nurse Practitioner | 520 Superior Ave, Suite 350, Newport Beach, CA 92663 | 2011-05-11 |
| 1043500390 | Romit Kumar Kar | Pediatrics | 355 Placentia Ave Ste 301, Newport Beach, CA 92663 | 2011-04-07 |
| 1477858546 | Newport Neurohospitalists | Neurological Surgery | 510 Superior Ave Ste 280, Newport Beach, CA 92663 | 2011-01-20 |
| Find all providers in zip 92663 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518599596 | Hanna Marie Jantzi | Physician Assistant | 3501 Jamboree Rd # 1250, Newport Beach, CA 92660-2939 | 2020-02-07 |
| 1760012397 | Chiara Rundle | Physician Assistant | 308 Columbia St, Newport Beach, CA 92663-2305 | 2020-01-23 |
| 1780220772 | Noelle Joy Kraus | Physician Assistant | 20301 Sw Birch St Ste 100, Newport Beach, CA 92660-1754 | 2019-11-25 |
| 1902397219 | Ashley Mergelmeyer | Physician Assistant | 2332 Baypointe Dr, Newport Beach, CA 92660-8520 | 2018-05-22 |
| 1235645052 | Jennifer T Le | Physician Assistant | 2430 W Coast Hwy, Newport Beach, CA 92663-4780 | 2017-12-15 |
| 1679009856 | Morgan Surfas | Physician Assistant | 600 Newport Center Dr Ste 150, Newport Beach, CA 92660-6418 | 2017-05-07 |
| 1073049375 | Kristen Kichline | Physician Assistant | 2115 Sherington Pl Apt D314, Newport Beach, CA 92663-6603 | 2017-05-05 |
| 1619271038 | Yoomi Cho | Physician Assistant | 1401 Avocado Ave Ste 703, Newport Beach, CA 92660-8710 | 2010-12-28 |
| 1023282019 | Sally E. Decastro-tilsen | Physician Assistant | 400 Newport Center Dr Ste 701, Newport Beach, CA 92660-7608 | 2008-04-22 |
| 1396921573 | Brandie Rulfs Walton | Physician Assistant | 400 Newport Center Dr. Ste 500, Newport Beach, CA 92660 | 2008-01-17 |
| Find all providers in NEWPORT BEACH | ||||
| City | NEWPORT BEACH |
| Zip Code | 92663 |
Please comment or provide details below to improve the information on JENNIFER 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.