ANDREA WILLEY, MD - NPI NUMBER 1952317455

Summary

Provider Name: ANDREA WILLEY, MD

NPI Number: 1952317455

Clasification: Dermatology (207NS0135X)

Specialization: Procedural Dermatology

Organization: ANDREA WILLEY MD A PROFESSIONAL MEDICAL CORPORATION

Address:
2277 FAIR OAKS BLVD
SUITE 402
SACRAMENTO, CA
ZIP 95825

Phone Number: (916) 922-7546



Detailed Information

Andrea Willey, MD is a procedural dermatologist in Sacramento, CA with 14 years of experience. The provider is procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). The assigned NPI number for this provider is 1952317455 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO SCHOOL OF MEDICINE
Graduation Year: 2000

The provider's business address is:

2277 FAIR OAKS BLVD
SUITE 402
SACRAMENTO, CA
ZIP 95825-533
Phone: (916) 922-7546

The enumeration date for this NPI number is 8/1/2006 and was last updated on 11/1/2013.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207NS0135X Dermatology Procedural Dermatology A75733 CA No
2 207N00000X Dermatology MD26877 OR Yes

NPI Record

No. Field Name Field Value
1 NPI 1952317455
2 Entity Type Code 1
3 Provider Last Name Legal Name WILLEY
4 Provider First Name ANDREA
5 Provider Credential Text MD
6 Provider First Line Business Practice Location Address 2277 FAIR OAKS BLVD
7 Provider Second Line Business Practice Location Address SUITE 402
8 Provider Business Practice Location Address City Name SACRAMENTO
9 Provider Business Practice Location Address State Name CA
10 Provider Business Practice Location Address Postal Code 958255533
11 Provider Business Practice Location Address Country Code If outside U S US
12 Provider Business Practice Location Address Telephone Number 9169227546
13 Provider Enumeration Date 8/1/2006
14 Last Update Date 11/1/2013
15 Provider Gender Code F
16 Healthcare Provider Taxonomy Code 1 207NS0135X
17 Provider License Number 1 A75733
18 Provider License Number State Code 1 CA
19 Healthcare Provider Primary Taxonomy Switch 1 N
20 Healthcare Provider Taxonomy Code 2 207N00000X
21 Provider License Number 2 MD26877
22 Provider License Number State Code 2 OR
23 Healthcare Provider Primary Taxonomy Switch 2 Y
24 Is Sole Proprietor Y

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This page was last updated on: 10/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.