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ANDRE WILSON
NPI 1013545805
Registered Nurse - Psychiatric/Mental Health in Eureka, CA

Active since March 29, 2020

NPPES record last updated: May 6, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 6, 2021, Mar 29, 2020 (2 updates tracked since 2020).

About Andre Wilson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ANDRE WILSON (NPI 1013545805) is an individual psychiatric/mental health provider in Eureka, California, licensed in California (95213323) and active in the NPI registry since March 2020. He maintains a secondary practice location in San Diego.

NPPES Registry Identity

NPI1013545805
Entity TypeIndividualMale
Primary Taxonomy163WP0808X
Provider Legal NameANDRE WILSON
Location Address720 WOOD STEureka, CA 95501-4413
Mailing Address720 Wood StEureka, CA 95501-4413
Phone(707) 268-2990
Sole ProprietorNo
Enumeration DateMarch 29, 2020
Last NPPES UpdateMay 6, 20212 updates tracked since enumeration
NPPES CertifiedMay 6, 2021
✔ NPI 1013545805 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered Nurse · Psychiatric/Mental HealthNursing Service Providers
Taxonomy Code163WP0808X
License✔ Licensed in CA · 95213323
720 WOOD ST, Eureka, CA 95501
Open in Google Maps ↗

Secondary Practice Location 1

Location 11045 9th AveSan Diego, CA 92101-5504 · Phone (619) 235-2600

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS ASHLEY DAWN KINMAN
Case Manager/Care Coordinator
720 WOOD ST
EUREKA, CA 95501
Humboldt County (707) 268-2990
SOUTHERN CALIFORNIA NEUROLOGY AND PSYCHIATRY INC
Psychiatry & Neurology (Neurology)
720 WOOD ST
EUREKA, CA 95501
Humboldt County (707) 502-5519
JACQUELYN WHITE
Counselor (Mental Health)
720 WOOD ST
EUREKA, CA 95501
Humboldt County (707) 268-2990
SHAWNA RECKINGER RN
Registered Nurse (Psychiatric/Mental Health)
720 WOOD ST
EUREKA, CA 95501
Humboldt County (707) 268-2990
ALLISON JUDY PHILLIPS RN
Registered Nurse (Psychiatric/Mental Health)
720 WOOD ST
EUREKA, CA 95501
Humboldt County (707) 268-2990
AIMEE LEEANNE WOODS LVN
Licensed Vocational Nurse
720 WOOD ST
EUREKA, CA 95501
Humboldt County (707) 268-2990
ERIC CARL VEDBORG LMFT
Marriage & Family Therapist
720 WOOD ST
EUREKA, CA 95501
Humboldt County (707) 268-2935
MS. LESLIE ANN PETERSEN
Registered Nurse
720 WOOD ST, HUMBOLDT COUNTY MENTAL HEALTH
EUREKA, CA 95501
Humboldt County (707) 445-7710

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Andre Wilson's NPI number?

The NPI number for Andre Wilson is 1013545805. It was assigned to this individual provider in the NPPES registry on March 29, 2020.

Where is Andre Wilson located?

Andre Wilson practices at 720 Wood St, Eureka, CA 95501. The listed phone number is (707) 268-2990.

What is Andre Wilson's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in Psychiatric/Mental Health, with taxonomy code 163WP0808X.

When was this NPI record last updated?

The NPPES record for Andre Wilson was last updated on May 6, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.