Individual
MS. DARLENE ELIZABETH WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
450 BAUCHET ST, LOS ANGELES, CA 90012-2907
(213) 473-6117
Mailing address
450 BAUCHET ST, LOS ANGELES, CA 90012-2907
(213) 473-6117
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
496212
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E444522
CORRECTIONS
CA
Enumeration date
01/02/2020
Last updated
01/02/2020
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