Wilson, Jeffrey Grant

Wilson, Jeffrey Grant is an sole proprietor health care provider with primary practice located at 27725 Santa Margarita Pkwy Suite 215, Mission Viejo CA 92691-6704. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Wilson, Jeffrey Grant can be contacted via phone (949) 272-3870.

Contact Information

Primary practice address
27725 Santa Margarita Pkwy Suite 215 Mission Viejo CA 92691-6704
Phone: (949) 272-3870
Fax: (949) 951-2802
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY12832 California

Profile Details

NPI number 1245277979
LBN Legal business name Wilson, Jeffrey Grant
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 1st, 2006
Last updated Nov 21st, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245277979 NPPES
California Other W19141A MEDICARE GROUP ID

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