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JAMES CLINTON WILSON PH.D.
NPI 1902932783
Clinical Neuropsychologist in San Rafael, CA

Active since February 26, 2007PECOS EnrolledAccepts Medicare Assignment
712 D ST STE N, SAN RAFAEL, CA 94901(415) 485-1939(415) 485-1939 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About James Clinton Wilson Ph.d. NPPES

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

JAMES CLINTON WILSON PH.D. (NPI 1902932783) is an individual clinical neuropsychologist in San Rafael, California, licensed in California (PSY10276) and active in the NPI registry since February 2007. He is enrolled in Medicare PECOS and is a graduate of Other (1985).

NPPES Registry Identity

NPI1902932783
Entity TypeIndividualMale
Primary Taxonomy103G00000X
Provider Legal NameJAMES CLINTON WILSONCredential: PH.D.
Location Address712 D ST STE NSan Rafael, CA 94901-3706
Mailing Address49 Creekside DrSan Rafael, CA 94903-1076 · (415) 499-7767 · Fax (415) 485-1939
Phone(415) 485-1939
Fax(415) 485-1939
Sole ProprietorYes
Medical School CMSOtherGraduated 1985
Enumeration DateFebruary 26, 2007
Last NPPES UpdateJuly 8, 2007
✔ NPI 1902932783 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinical NeuropsychologistBehavioral Health & Social Service Providers
Taxonomy Code103G00000X
License✔ Licensed in CA · PSY10276
Definition
A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing the understanding of brain-behavior relationships and the application of such knowledge to human problems.
712 D ST STE N, San Rafael, CA 94901
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Other Names 1

Professional Name (2)Dr. James Clinton Wilson Ph.d.

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

James Clinton Wilson Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID5698837466
PECOS Enrollment IDI20090105000125
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

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 James Wilson's NPI number?

The NPI number for James Wilson is 1902932783. It was assigned to this individual provider in the NPPES registry on February 26, 2007. The provider is also known as Dr. James Clinton Wilson Ph.D..

Where is James Wilson located?

James Wilson practices at 712 D St Ste N, San Rafael, CA 94901. The listed phone number is (415) 485-1939.

What is James Wilson's specialty?

The primary specialty registered for this NPI is Clinical Neuropsychologist with taxonomy code 103G00000X.

Is James Wilson enrolled in Medicare?

Yes. James Wilson is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for James Wilson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.