Individual
BLAKE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3150 18TH ST STE 350, SAN FRANCISCO, CA 94110-2077
(510) 619-2597
Mailing address
3150 18TH ST STE 350, SAN FRANCISCO, CA 94110-2077
(510) 619-2597
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/15/2026
Last updated
01/15/2026
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