Individual provider Active NPI

Carmen Wille

  • Psychologist
  • Rancho Cordova, CA
National Provider Identifier
1073412086
Registry record updated Nov 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
10487 White Rock Rd
Rancho Cordova, CA 95670-5530
Phone
(916) 294-2480
NPI assigned
Nov 4, 2026
Last updated
Nov 4, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X CA Primary

Addresses

Primary practice location

10487 White Rock Rd
Rancho Cordova, CA 95670-5530

Mailing address

9004 Canberra Dr
Sacramento, CA 95826-4415
Phone (916) 612-1397

Other practice location 1

10700 Ambassador Dr
Rancho Cordova, CA 95670-2406
Phone (916) 294-2435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1793750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1793750400000",
    "number": "1073412086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9004 CANBERRA DR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958264415",
            "telephone_number": "916-612-1397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10487 WHITE ROCK RD",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956705530",
            "telephone_number": "916-294-2480"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10700 Ambassador Dr",
            "address_purpose": "LOCATION",
            "city": "Rancho Cordova",
            "state": "CA",
            "postal_code": "956702406",
            "country_code": "US",
            "telephone_number": "916-294-2435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLE",
        "first_name": "CARMEN",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-11-04",
        "last_updated": "2026-11-04",
        "certification_date": "2026-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.