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1265019053
TIMOTHY JOSEPH WILSON
HAYWARD, CA
NPI
1265019053
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA 14628-rac)
Enumeration Date
2021-03-26
Last Update Date
2021-03-26
Business Address
TIMOTHY JOSEPH WILSON
107 JACKSON ST
HAYWARD, CA 94544-1948
Phone number: 510-886-8696
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Mailing Address
TIMOTHY JOSEPH WILSON
21739 PRINCETON ST APT 4
HAYWARD, CA 94541-3888
Phone number: 408-910-3988
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