Individual
BREANNA NICOLE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1382 BLUE OAKS BLVD STE 213, ROSEVILLE, CA 95678-7052
(909) 234-6882
Mailing address
12486 CHESTNUT PL, CHINO, CA 91710-2619
(909) 234-6882
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
Primary
F52B75186E
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/27/2025
Last updated
04/03/2026
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