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General NPI Number Information
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NPI Number | 1124839386
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Entity Type | Individual
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Provider Name | MEGAN WILSON
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Gender | Female
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 3180 WESTWOOD LN
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City | OCCIDENTAL
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State | CA
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Zip | 95465-9220
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Country | US
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Telephone | 510-646-3692
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 535
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City | OCCIDENTAL
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State | CA
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Zip | 95465-0535
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Country | US
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Telephone | 510-646-3692
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 374J00000X
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Taxonomy Name | Doula
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License Number |
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License Number State |
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