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MR. JEFFREY MATTHEW WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
5 HUTTON CENTRE DR STE 950, SANTA ANA, CA 92707-8714
(855) 434-7763
Mailing address
7750 VIA FRANCESCO UNIT 2, SAN DIEGO, CA 92129-5149
(562) 682-5069

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95033035
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95033035
CA

Other

Enumeration date
03/30/2011
Last updated
06/09/2025
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