Brigitte Yvonne Willis, M.D., PH.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

A128724 Issued in CA

Practice address

1627 S Hargrave St
Banning, CA 92220

Phone

(951) 922-7852

NPI assigned

Aug 28, 2012

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, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine, Doctor of Philosophy

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 and National Provider Directory roles.

• Department of State Hospitals

  dba Coalinga State Hospital

  • Psychiatric Hospital
  • Coalinga, CA
  • NPI 1124078704
  Medicare reassignment NPD
• Riverside-San Bernardino County Indian Health, Inc.

  dba San Manuel Indian Health

  • Federally Qualified Health Center (FQHC)
  • Grand Terrace, CA
  • NPI 1174676670

  TX

  Medicare reassignment NPD
• Department of State Hospitals

  dba Department of State Hospitals - Patton

  • Psychiatric Hospital
  • Patton, CA
  • NPI 1043249204
  NPD
• Department of State Hospitals

  dba Department of State Hospitals-Atascadero

  • Psychiatric Hospital
  • Atascadero, CA
  • NPI 1174573802
  NPD
• Riverside-San Bernardino County Indian Health, Inc

  dba Santa Rosa Indian Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Mountain Center, CA
  • NPI 1366028086
  NPD
• Riverside-San Bernardino County Indian Health, Inc.

  dba Torres Martinez Indian Health

  • Federally Qualified Health Center (FQHC)
  • Thermal, CA
  • NPI 1043363641
  NPD

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1114275930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9961 SIERRA AVE",
            "address_2": "DEPARTMENT OF FAMILY MEDICINE",
            "city": "FONTANA",
            "state": "CA",
            "postal_code": "923356720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1627 S HARGRAVE ST",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "92220",
            "telephone_number": "951-922-7852"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "BRIGITTE",
        "middle_name": "YVONNE",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A128724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Andrew Wilamart, RPH
• Glen Wiley, APRN, FNP-C
• Brittany Williams
• Cameo Williams
• John Gavin Williams, M.D
• Carlene Willis, FNP-C
• Celina Beatriz Wong Miller, MD
• Sam Duane Worrall
• Louis Charles Wright III
• Ting Wu, M.D.

• Family Medicine Physician in Banning, CA
• Providers in Banning, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; 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.