Healthcare Provider Details

I. General information

NPI: 1972427581
Provider Name (Legal Business Name): ISABELLA HELENE WILSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

FACTOR BLDG 700 TIVERTON AVE
LOS ANGELES CA
90095-0001
US

IV. Provider business mailing address

181 CIRCLE DR
WALNUT CREEK CA
94595-1708
US

V. Phone/Fax

Practice location:
  • Phone: 925-588-1482
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95040462
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: