Individual
DR. CAROL ASADA WILKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12625 HIGH BLUFF DR, SUITE 215, SAN DIEGO, CA 92130-2052
(858) 792-8300
(858) 408-2494
Mailing address
12625 HIGH BLUFF DR, SUITE 215, SAN DIEGO, CA 92130-2052
(858) 792-8300
(858) 408-2494
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PSY11669
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11699155
CAQH PROVIDER
CA
01
—
CP11669
MEDICARE
CA
01
—
OPL116690
BLUE SHIELD PROVIDER#
CA
Enumeration date
08/05/2006
Last updated
12/11/2015
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