Provider Demographics
NPI:1346741188
Name:BILL WILSON CENTER
Entity Type:Organization
Organization Name:BILL WILSON CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIVISION DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AUBRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MASTRANGELO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-278-2531
Mailing Address - Street 1:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-0127
Mailing Address - Country:US
Mailing Address - Phone:707-255-3300
Mailing Address - Fax:707-255-3527
Practice Address - Street 1:1671 THE ALAMEDA STE 201
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2222
Practice Address - Country:US
Practice Address - Phone:408-278-2530
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BILL WILSON CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-02-27
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health