| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JUANITA WILSON | 1851918627 | 2020-06-28 |
Juanita Wilson is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1851918627. Registration indicates Juanita Wilson is a provider of services with a specialization in Behavioral Health & Social Service Providers, Marriage & Family Therapist (Marriage & Family Therapist, ) (Behavioral Health/Substance Abuse/Psychiatry, ) (Marriage & Family Therapist, Behavioral Health & Social Service Providers)
| Entity Type | Individual |
| Provider Name | Mrs. Juanita Wilson AMFT |
| Practice Office Address | 2275 S MAIN ST STE 201 CORONA, CA US |
| Practice Office Telephone | 9512793222 |
| Mailing Address | 18350 MOUNT LANGLEY ST STE 220 FOUNTAIN VALLEY, CA 927086912 US |
| Business Telephone | 7144504118 |
| Code | Practice | License No State |
|---|---|---|
| 106H00000X PRIMARY | Behavioral Health & Social Service Providers Marriage & Family Therapist Marriage & Family Therapist Behavioral Health/Substance Abuse/Psychiatry Marriage & Family Therapist Behavioral Health & Social Service Providers |
CA |