Haidy Denise Willis, PMHNP

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

NP 22719 Issued in CA

Practice address

10333 El Camino Real
Atascadero, CA 93422-5808

Phone

(805) 468-2000

Fax

(805) 468-6011

NPI assigned

Nov 3, 2011

Last updated

Jul 10, 2013By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Central Coast Behavioral Health, Inc.

  • Psychiatry Physician
  • Arroyo Grande, CA
  • NPI 1699112698
  Medicare reassignment NPD
• Behavioral Health Solutions

  dba Behaviorial Health of Bardwell

  • Psychiatric/Mental Health Nurse Practitioner
  • Bardwell, KY
  • NPI 1942803135
  NPD Authorized official
• Palm Desert Psychiatry Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Palm Desert, CA
  • NPI 1487277257
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1320278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1373414400000",
    "number": "1023395142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 9TH STREET, ROOM 150",
            "address_2": "FISCAL ALLOCATIONS AND ESTIMATES UNIT",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958146414",
            "telephone_number": "916-651-9475",
            "fax_number": "916-651-8908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10333 EL CAMINO REAL",
            "city": "ATASCADERO",
            "state": "CA",
            "postal_code": "934225808",
            "telephone_number": "805-468-2000",
            "fax_number": "805-468-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "HAIDY",
        "middle_name": "DENISE",
        "name_prefix": "Mrs.",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-03",
        "last_updated": "2013-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "CA",
            "license": "NP 22719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cali Rene Williams, PT
• Melanie Nicole Williams, PSYD
• Timothy Scott Williams, PMHNP
• Zachary Williams
• Daniel Wade Willis, D.C.
• Lester James Willis, DNP, PMHNP-BC
• Kelly Wills, MS, RD
• Lindsey Wilson
• Alicia Winchester, AA, BA
• Shane Erin Wing, MD

• Adult Psychiatric/Mental Health Registered Nurse in Atascadero, CA
• Providers in Atascadero, CA by specialty
• Adult Psychiatric/Mental Health Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.