Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Taylor Kettle Wilson, PA-C

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1710573134

Taylor Kettle Wilson, PA-C is a Student in an Organized Health Care Education/Training Program in Rancho Cucamonga, California. Practices as a sole proprietor. Registered with an NPI since 2020.

In the registry since
2020
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

10601 Church St 105
Rancho Cucamonga, CA 91730
Phone: (909) 989-7100
Fax: (909) 989-6333
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1710573134
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedDecember 19, 2020
Last updated in NPPESOctober 31, 2024
Certification dateDecember 19, 2020

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