Individual
CASPER S WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1211 W VISTA WAY BLDG C, VISTA, CA 92083-6227
(760) 721-2781
Mailing address
1400 N JOHNSON AVE STE 101, EL CAJON, CA 92020-1651
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1560290524
CA
Other
Enumeration date
11/28/2023
Last updated
05/07/2024
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