Healthcare Provider Details

I. General information

NPI: 1245183300
Provider Name (Legal Business Name): ARY WILSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2026
Last Update Date: 02/18/2026
Certification Date: 02/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6939 SUNRISE BLVD STE 100
CITRUS HEIGHTS CA
95610-3153
US

IV. Provider business mailing address

6939 SUNRISE BLVD STE 100
CITRUS HEIGHTS CA
95610-3153
US

V. Phone/Fax

Practice location:
  • Phone: 916-677-9818
  • Fax:
Mailing address:
  • Phone: 916-677-9818
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number821528
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: