Provider Demographics
NPI:1780914093
Name:WILSON, TOSCA LIEN (MSW)
Entity type:Individual
Prefix:MS
First Name:TOSCA
Middle Name:LIEN
Last Name:WILSON
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:TOSCA
Other - Middle Name:LIEN
Other - Last Name:WILSON-DAVIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:65 DEROW CT
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95833-1919
Mailing Address - Country:US
Mailing Address - Phone:916-568-6482
Mailing Address - Fax:
Practice Address - Street 1:900 FULTON AVE
Practice Address - Street 2:SUITE 205
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4500
Practice Address - Country:US
Practice Address - Phone:916-393-1222
Practice Address - Fax:916-484-3570
Is Sole Proprietor?:No
Enumeration Date:2010-01-08
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program