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

Individual provider Massage Therapist · NPI 1770181521

Miss. Ebonique Zanale Wilson is a Massage Therapist in San Jose, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2020
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Practice location Address checks out

380 Vista Roma Way Unit 316
San Jose, CA 95136-4421
Phone: (408) 603-7012
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Massage Therapist (primary) Taxonomy 225700000X · Licence 12550 (CA)

Record details

NPI number1770181521
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 14, 2020
Last updated in NPPESOctober 14, 2020
Certification dateOctober 14, 2020

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