Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Wayne Wilson Licensed Clinical Social Worker Inc

Organization Clinical Social Worker · NPI 1457148405

Wayne Wilson Licensed Clinical Social Worker Inc is a Clinical Social Worker in Costa Mesa, California. Registered with an NPI since 2025.

In the registry since
2025
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

605 Town Center Dr
Costa Mesa, CA 92626
Phone: (949) 949-0009
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1457148405
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Katelyn Dungo — Human Resources · (208) 869-8386
NPI enumeratedApril 23, 2025
Last updated in NPPESApril 23, 2025
Certification dateApril 15, 2025
Mailing address605 Town Center Dr., Costa Mesa, CA 92626

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