| Thomas Theodore Wilson, LCSW | |
| 5025 Collwood Way Unit 18, San Diego, CA 92115-2052 | |
| (315) 569-0809 | |
| Not Available | 
| Full Name | Thomas Theodore Wilson | 
|---|---|
| Gender | Male | 
| Speciality | Social Worker - Clinical | 
| Location | 5025 Collwood Way Unit 18, San Diego, California | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1083465264 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 116209 (California) | Primary | 
| Entity Name | Grow Healthcare Group Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1154994846 PECOS PAC ID: 1850774746 Enrollment ID: O20220809004080 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Thomas Theodore Wilson, LCSW 5025 Collwood Way Unit 18, San Diego, CA 92115-2052 Ph: (315) 569-0809 | Thomas Theodore Wilson, LCSW 5025 Collwood Way Unit 18, San Diego, CA 92115-2052 Ph: (315) 569-0809 | 
| Ms. Sonya None Starr, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 4660 Palm Ave, San Diego, CA 92154 Phone: 619-662-5000 | |
| Evelina Jaime, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 286 Euclid Ave, Suite 102, San Diego, CA 92114 Phone: 619-266-2111 Fax: 619-266-0496 | |
| Channing Gredvig, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 3420 Kenyon St, San Diego, CA 92110 Phone: 619-221-6550 Fax: 619-221-6556 | |
| Mr. Javier Perez, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 2305 Meade Ave, 3, San Diego, CA 92116 Phone: 619-787-2534 | |
| Noemi Ana Mitzel, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6977 Navajo Rd # 654, San Diego, CA 92119 Phone: 619-382-8662 | |
| Leah Bogopulsky, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 3020 Childrens Way # 5100, San Diego, CA 92123 Phone: 858-966-1700 | |
| Dawnn Marie Mendoza Guray, ASW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 8775 Aero Dr Ste 132, San Diego, CA 92123 Phone: 858-609-8742 |