Individual
ALICIA WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3301 E 12TH ST STE 259, OAKLAND, CA 94601-2940
(510) 295-9632
(510) 269-9031
Mailing address
PO BOX 7026, OAKLAND, CA 94601-0026
(510) 295-9632
(510) 269-9031
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
106533
CA
106H00000X
Marriage & Family Therapist
Primary
139885
CA
106S00000X
Behavior Technician
RBT-18-54640
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
CA
Other
Enumeration date
10/11/2018
Last updated
06/14/2023
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