Healthcare Provider Details

I. General information

NPI: 1013379205
Provider Name (Legal Business Name): LUKE WILKERSON M.S.M.F.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2016
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 REDCLIFF DR STE 225
REDDING CA
96002-0166
US

IV. Provider business mailing address

448 REDCLIFF DR STE 225
REDDING CA
96002-0166
US

V. Phone/Fax

Practice location:
  • Phone: 619-365-9956
  • Fax:
Mailing address:
  • Phone: 619-365-9956
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number106766
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: