Individual
CANDY JANE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4441 AUBURN BLVD, SACRAMENTO, CA 95841-4139
(916) 473-5764
Mailing address
8912 VOLUNTEER LN, SACRAMENTO, CA 95826-3221
(916) 344-0199
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
172V00000X
Community Health Worker
—
—
175T00000X
Peer Specialist
Primary
MPSS-UJSXAN
CA
Other
Enumeration date
09/21/2018
Last updated
09/22/2023
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