Provider Demographics
NPI:1891889580
Name:WILSON, CHRISTINE E
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:E
Last Name:WILSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:699 HAMPSHIRE RD STE 215
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91361-2351
Mailing Address - Country:US
Mailing Address - Phone:818-991-3800
Mailing Address - Fax:188-991-3804
Practice Address - Street 1:699 HAMPSHIRE RD STE 215
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91361-2351
Practice Address - Country:US
Practice Address - Phone:818-991-3800
Practice Address - Fax:818-991-3804
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA3898237700000X
CA2027237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist