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Contact Information

SALLY WILSON, FNP
4456 DAWES AVE
CULVER CITY, CA90230
 Phone: 310-319-4503
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Women's Health Care, Ambulatory

163WW0101X
Indicates primary specialty

NPI Profile & details for SALLY WILSON · (Female)

NPI # 1255673893
Status Active
Credentials FNP (Family Nurse Practitioner)
Entity Individual
Enumeration date 03/21/2013
Last updated 03/21/2013 - About 13 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # 13414
  • CA License # 514467
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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