Lawrence David Willison IV, M.D., PH.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

A111776 Issued in CA

Practice address

760 Westwood PLZ
Suite C8-225, Box 951759
Los Angeles, CA 90024-5055

Phone

(310) 825-0548

NPI assigned

Nov 5, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299542400000",
    "number": "1104070010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 WESTWOOD PLZ",
            "address_2": "SUITE C8-551",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 WESTWOOD PLZ",
            "address_2": "SUITE C8-225, BOX 951759",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900245055",
            "telephone_number": "310-825-0548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLISON",
        "first_name": "LAWRENCE",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-05",
        "last_updated": "2011-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A111776",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Willis, RRT
• Rashaad Willis
• Shannon Leigh Willis, M.S.W., B.C.B.A.
• Sharey Willis
• Zachary Dynell Willis
• Alan Gerald Willner, PH.D.
• Carol Siegal Willner, PHD
• Emily Liza Willner, MD
• Rebecca Willner, MSW
• Yvette Alicia Willock

• Psychiatry Physician in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.