MOLLY WILLIS NPI 1275921264

NPI Information

NPI: 1275921264
Provider Name: MOLLY WILLIS
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
140 ARBOR DR
SAN DIEGO, CA
ZIP 92103
Phone: (619) 543-7795
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Molly Willis is a psychiatric/mental health nurse practitioner in San Diego, CA with 11 years of experience. Molly Willis NPI is 1275921264. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: BRODY SCHOOL OF MEDICINE AT EAST CAROLINA UNIVERSITY
Graduation Year:2013

The provider's business location address is:

140 ARBOR DR
SAN DIEGO, CA
ZIP 92103-007
Phone: (619) 543-7795

The NPI 1275921264 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/30/2014 and was last updated on 12/13/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. 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	163W00000X	Registered Nurse		95042597	CALIFORNIA	No
2	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	95004719	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	95042597	OTHER	CALIFORNIA	CALIFORNIA BOARD OF REGISTERED NURSING
2	95004719	OTHER	CALIFORNIA	CALIFORNIA BOARD OF REGISTERED NURSING

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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