Individual
ALEXANDRIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2424 HURLEY WAY APT 10, SACRAMENTO, CA 95825-3651
(951) 567-3820
Mailing address
7996 LA RIVIERA DR APT 7, SACRAMENTO, CA 95826-1617
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
171M00000X
171M00000X
—
Enumeration date
05/19/2017
Last updated
05/16/2019
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