Mrs Kelly Ann Wilson, is a
Social Worker - Clinical based in Altadena, California. Mrs Kelly Ann Wilson is licensed to practice in California (license number 104732) and her current practice location is
760 Mountain View St, Altadena, California. She can be reached at her office (for appointments etc.) via phone at
(626) 798-6793.
NPI number for Mrs Kelly Ann Wilson is 1528619160 and her current mailing address is 867 N Fair Oaks Ave, Pasadena, California. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1528619160.
Healthcare Provider's Profile
| Full Name | Mrs Kelly Ann Wilson |
|---|
| Gender | Female |
|---|
| Speciality | Social Worker - Clinical |
|---|
| Location | 760 Mountain View St, Altadena, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1528619160
- Provider Enumeration Date: 09/25/2019
- Last Update Date: 11/12/2024
Medical Identifiers
Medical identifiers for Mrs Kelly Ann Wilson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1528619160 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | 104732 (California) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (California) | Secondary |
| 1041C0700X | Social Worker - Clinical | 104732 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Kelly Ann Wilson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mrs Kelly Ann Wilson,
867 N Fair Oaks Ave,
Pasadena, CA 91103-3050
Ph: (626) 798-6793 | Mrs Kelly Ann Wilson,
760 Mountain View St,
Altadena, CA 91001-4996
Ph: (626) 798-6793 |
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