Olivia Jane Wilson, PA-C
Physician Assistant in La Jolla, CA. Individual provider (NPI-1).
NPI number1962362020
StatusActive
Last updated in NPPESApr 9, 2026
Details
- NPI
- 1962362020
- Entity type
- Individual (NPI-1)
- Name
- Ms. Olivia Jane Wilson
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 12, 2025
- Certification date
- Apr 9, 2026
- Last updated
- Apr 9, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | PA67272 | CA | Yes |
Practice location
4150 Regents Park Row Ste 230La Jolla, CA 92037-1414
Phone 858-207-3117 · Fax 858-240-4029
Mailing address
958 B AveCoronado, CA 92118-2606
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