Individual provider Active NPI

Vicki Asher Wills, PSYD, LCSW

  • Clinical Social Worker
  • San Clemente, CA
National Provider Identifier
1265740427
Registry record updated Sep 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC15030 Issued in CA
Practice address
128 Avenida del Mar
2E
San Clemente, CA 92672-4080
Phone
(949) 648-1213
Fax
(949) 498-8111
NPI assigned
Sep 21, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LC15030 CA Primary

Addresses

Primary practice location

128 Avenida del Mar
2E
San Clemente, CA 92672-4080

Mailing address

3 Via Cancion
San Clemente, CA 92673-6907
Phone (949) 648-1213

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

State licenses

LicenseStateTypeSpecialty
LC15030CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285027200000",
    "number": "1265740427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 VIA CANCION",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926736907",
            "telephone_number": "949-648-1213",
            "fax_number": "949-498-8111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 AVENIDA DEL MAR",
            "address_2": "2E",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724080",
            "telephone_number": "949-648-1213",
            "fax_number": "949-498-8111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHER WILLS",
        "first_name": "VICKI",
        "name_prefix": "Dr.",
        "credential": "PSYD, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-09-21",
        "last_updated": "2010-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "LC15030",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Clemente, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.