MISS CORAL LYNN WILSON (NPI# 1063919769) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063919769 |
| Entity Type | Individual |
| Full Name | MISS CORAL LYNN WILSON |
| Credential | RADT |
| Practice Address |
4049 Miller Way Sacramento CA 95817-1332 |
| Mailing Address |
3716 Fielding Cir Sacramento CA 95826-4420 |
| Practice Telephone | 9164519312 |
| Practice Fax Number | 9164519312 |
| Mailing Telephone | 9162569801 |
| Enumeration Date | 2018-04-09 |
| Last Update Date | 2018-04-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GATEWAY | C340020 | 01 |
| Street Address |
4049 MILLER WAY |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95817-1332 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497748107 | Gateway Foundation, Inc. | Substance Abuse Rehabilitation Facility | 4049 Miller Way, Sacramento, CA 95817-1332 | 2005-08-26 |
| 1043818917 | Ineeka Lashae' Bowens | Counselor | 4049 Miller Way, Sacramento, CA 95817-1332 | 2020-10-13 |
| 1013542000 | Bridget Adams | Counselor | 4049 Miller Way, Sacramento, CA 95817-1332 | 2020-03-10 |
| 1205474855 | Andrewline Denise Lewis | Counselor | 4049 Miller Way, Sacramento, CA 95817-1332 | 2019-12-13 |
| 1699325068 | Monica Kay Patterson | Counselor | 4049 Miller Way, Sacramento, CA 95817-1332 | 2019-09-17 |
| 1659921146 | Robin Marie Montero | Counselor | 4049 Miller Way, Sacramento, CA 95817-1332 | 2019-09-16 |
| 1053871509 | Lisa Michelle Gish | Counselor | 4049 Miller Way, Sacramento, CA 95817-1332 | 2019-03-21 |
| 1669969416 | Karen Leanne Shirley | Counselor | 4049 Miller Way, Sacramento, CA 95817-1332 | 2018-04-17 |
| 1790295962 | Kathleen Marie Granlund | Counselor | 4049 Miller Way, Sacramento, CA 95817-1332 | 2017-10-02 |
| 1619402815 | Amy Bray | Community Health Worker | 4049 Miller Way, Sacramento, CA 95817-1332 | 2017-04-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346855103 | Quintin Kuse | Student in an Organized Health Care Education/Training Program | 4610 X Street, Sacramento, Sacramento, CA 95817 | 2020-09-09 |
| 1285259283 | Uc Davis Health | Dietitian, Registered | 2315 Stockton Blvd Sesp 0160, Sacramento, CA 95817 | 2020-06-15 |
| 1942840558 | Michael Marchand-gareau | Ophthalmology | Michael Marchand - Uc Davis Eye Center, 4860 Y Street, Suite 2400, Sacramento, CA 95817 | 2020-01-11 |
| 1467010728 | Jiunn Liang Jonathan Yap | Student in an Organized Health Care Education/Training Program | 4860 Y Str, Ste. 2820, Sacramento, CA 95817 | 2019-06-03 |
| 1083176614 | Kevin Lee | Student in an Organized Health Care Education/Training Program | 2315 Stockton Blvd, Op512, Sacramento, CA 95817 | 2019-04-02 |
| 1508326703 | Ritika Johal | Student in an Organized Health Care Education/Training Program | 4150 V Street, Pssb 1200, Sacramento, CA 95817 | 2019-03-22 |
| 1811468838 | Paige Palsgaard | Behavior Technician | 6730 4th Ave Apt 1731d, Sacramento, CA 95817 | 2018-12-17 |
| 1922503408 | Marie Rossi | Student in an Organized Health Care Education/Training Program | 4150 V Street #1100, Sacramento, CA 95817 | 2018-03-27 |
| 1639673791 | Sean Lam | Student in an Organized Health Care Education/Training Program | 4150 V Street #1200, Sacramento, CA 95817 | 2018-03-22 |
| 1124555388 | Tatyana Polyak | Surgery | 2335 Stockton Blvd., Naob 6th Floor, Sacramento, CA 95817 | 2017-05-18 |
| Find all providers in zip 95817 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508472440 | Jamie Lee Byrnes | Counselor | 777 12th St Ste 250, Sacramento, CA 95814-1929 | 2020-09-16 |
| 1104431519 | Sally Kathleen Montazer | Counselor | 1134 Clinton Rd, Sacramento, CA 95825-7304 | 2020-09-11 |
| 1255958187 | Douglas Benjamin Gudeman | Counselor | Alternative House-residential Treatment Center, 1550 Juliesse Avenue, Sacramento, CA 95815 | 2020-06-26 |
| 1972127611 | Brianna Hope Barron | Counselor | 8950 Cal Center Dr Ste 160&165, Sacramento, CA 95826-3259 | 2020-05-28 |
| 1699398420 | Selena Marie Brown | Counselor | 8084 Weeping Willow Ln, Sacramento, CA 95828-5395 | 2020-05-27 |
| 1346863222 | Erin Harris | Counselor | 2819 Norcade Cir Apt 1, Sacramento, CA 95826-3427 | 2020-05-26 |
| 1023638566 | Marta Yomara Rodriguez | Counselor | 5311 College Oak Dr Apt 16, Sacramento, CA 95841-2575 | 2020-04-24 |
| 1033739321 | Yancey Outreach International Inc. | Counselor | 1457 Dreamy Way, Sacramento, CA 95835-1761 | 2020-04-16 |
| 1114554136 | Cassandra Arlene Del Toro Ruiz | Counselor | 2403 Yreka Ave # 15, Sacramento, CA 95822-4466 | 2020-03-27 |
| 1952931487 | Anisa Sims | Counselor | 2688 Stonecreek Dr Apt 137, Sacramento, CA 95833 | 2020-01-23 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95817 |
Please comment or provide details below to improve the information on MISS CORAL LYNN WILSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.