Provider Demographics
NPI:1932085560
Name:WILSON, NATALIE (PPS)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:WILSON
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 FRANK HENGEL WAY
Mailing Address - Street 2:
Mailing Address - City:OAKLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94561-3712
Mailing Address - Country:US
Mailing Address - Phone:925-625-6840
Mailing Address - Fax:925-625-6850
Practice Address - Street 1:4901 FRANK HENGEL WAY
Practice Address - Street 2:
Practice Address - City:OAKLEY
Practice Address - State:CA
Practice Address - Zip Code:94561-3712
Practice Address - Country:US
Practice Address - Phone:925-625-6840
Practice Address - Fax:925-625-6850
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchoolGroup - Multi-Specialty