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NPI Code Detail

MEDICARE: DR. SARAH ELIZABETH WILSON PH.D.

MEDICARE:  DR. SARAH ELIZABETH WILSON  PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC1900XCounseling Psychologist25884CA

General Provider Information

NPI Number : 1881771087
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SARAH ELIZABETH WILSON PH.D.
Provider Business Mailing Address
First Line : 2912 FILLMORE ST
Second Line :
City : ALAMEDA
State : CA
Zip : 94501-5423
Country : US
Telephone Number : 510-775-1551
Fax Number :
Provider Business Practice Location Address
First Line : 23 ALTARINDA RD STE 205
Second Line :
City : ORINDA
State : CA
Zip : 94563-2608
Country : US
Telephone Number : 510-775-1551
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 03/17/2018

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Directions to “ DR. SARAH ELIZABETH WILSON PH.D.” Practice Location

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