Sandra E Willis, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

G51347 Issued in CA

Practice address

4629 Whitney Ave
Ste 2
Sacramento, CA 95821

Phone

(916) 482-9800

Fax

(916) 482-0537

NPI assigned

Jul 10, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1225062847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4629 WHITNEY AVE",
            "address_2": "STE 2",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95821",
            "telephone_number": "916-482-9800",
            "fax_number": "916-482-0537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4629 WHITNEY AVE",
            "address_2": "STE 2",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "95821",
            "telephone_number": "916-482-9800",
            "fax_number": "916-482-0537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "SANDRA",
        "middle_name": "E",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "G51347",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC",
            "identifier": "G51347",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Henry Willis, PH.D
• Jeffrey Ryuta Willis, M.D., PHD
• Lindsay Willis
• Madison Grace Willis
• Roger F Willis III, MA, OPT, SUD
• Shawnna-Michaella Willis
• Susan Diane Willis, MA
• Wanda F. Willis
• Wendy Willis
• Adam Jordan Wills

• Internal Medicine Physician in Sacramento, CA
• Providers in Sacramento, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.