Individual provider · Type 1 NPI

Theresa Wilson

Family Nurse Practitioner · San Clemente, CA

NPI number 1760631592 Active

Practice location

724 S El Camino Real
San Clemente, CA 92672-4250

Fax (949) 493-5851

Mailing address

PO Box 35380
Las Vegas, NV 89133-5380

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X8242 (CA)

Family Nurse Practitioner: Definition to come...

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About NPI 1760631592

Theresa Wilson's National Provider Identifier is 1760631592, issued on Sep 17, 2008. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in San Clemente, CA. The record was last updated on Nov 30, 2025.