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Search › California › 1041C0700X

Blaine Wilson, LCSW, MED

NPI 1063883544 · on the registry since 2015 · sole proprietor

Practice

Address
10535 Hospital Way
Mather, CA 95655
Phone
(916) 843-6952
Organisation at this address
Va Nchcs
Va Mather
Martinez Vamc
Martinez Vamc
Nancy J. Wynn-Grundy
Inferred from a shared address, not stated in the registry.
Clinicians at this address
395

Registry record

Primary taxonomy
1041C0700X
1041C0700X
Licence states on file
LA
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2026-09-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California