Michele M. Willingham, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PSY15849 Issued in CA

Practice address

1619 E Chapman Ave
Fullerton, CA 92831-4015

Phone

(714) 420-1515

Fax

(714) 992-5259

NPI assigned

Nov 21, 2006

Sex

Female

Sole proprietor

Yes

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1225103609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 E CHAPMAN AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928314015",
            "telephone_number": "714-420-1515",
            "fax_number": "714-992-5259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 E CHAPMAN AVE",
            "city": "FULLERTON",
            "state": "CA",
            "postal_code": "928314015",
            "telephone_number": "714-420-1515",
            "fax_number": "714-992-5259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLINGHAM",
        "first_name": "MICHELE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY15849",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Josephine Williams
• Kendyl Marie Williams, B.S.
• Matthew John Williams
• Mekhi Williams
• Raejoia Williams
• McKayla Willis-Campos
• Lauren Willis
• Christy Black Willman, RN
• Daniela Wilmes, EDUCATION SPECIALIST
• Alexandra Wilson, LCSW

• Clinical Psychologist in Fullerton, CA
• Providers in Fullerton, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.