Individual provider Active NPI

Caroline Yukiko Willis

  • Health & Wellness Coach
  • Van Nuys, CA
National Provider Identifier
1154117968
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health & Wellness CoachTaxonomy code 171400000X
Practice address
14200 Runnymede St
Van Nuys, CA 91405-1435
Phone
(818) 389-1184
NPI assigned
Apr 17, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health & Wellness Coach 171400000X Primary

Addresses

Primary practice location

14200 Runnymede St
Van Nuys, CA 91405-1435

Mailing address

1823 Camden Ave Apt 3
Los Angeles, CA 90025-4449
Phone (504) 615-2796

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Girls Athletic Leadership Schools Los Angeles CurrentSince Apr 20, 2025 Accepting new patients

Locations

14200 Runnymede St
Van Nuys, CA 91405
Phone (818) 389-1174

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1744848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744848000000",
    "number": "1154117968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1823 CAMDEN AVE APT 3",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900254449",
            "telephone_number": "504-615-2796"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14200 RUNNYMEDE ST",
            "city": "VAN NUYS",
            "state": "CA",
            "postal_code": "914051435",
            "telephone_number": "818-389-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "CAROLINE",
        "middle_name": "YUKIKO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-17",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171400000X",
            "taxonomy_group": "",
            "desc": "Health & Wellness Coach",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Van Nuys, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.