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Individual

ANTOINETTE R WILSON-EDWARDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
480 CHADBOURNE RD, FAIRFIELD, CA 94534-9639
(707) 429-4440
Mailing address
480 CHADBOURNE RD, FAIRFIELD, CA 94534-9639
(510) 691-6063

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
171M00000X
Case Manager/Care Coordinator
CA
225400000X
Rehabilitation Practitioner
Primary

Other

Enumeration date
05/06/2022
Last updated
07/11/2025
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