Healthcare Provider Details

I. General information

NPI: 1891889580
Provider Name (Legal Business Name): CHRISTINE E WILSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

699 HAMPSHIRE RD STE 215
THOUSAND OAKS CA
91361-2351
US

IV. Provider business mailing address

699 HAMPSHIRE RD STE 215
WESTLAKE VILLAGE CA
91361-2351
US

V. Phone/Fax

Practice location:
  • Phone: 818-991-3800
  • Fax: 818-991-3804
Mailing address:
  • Phone: 818-991-3800
  • Fax: 188-991-3804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number2027
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number2027
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: