Active NPI
Leeza Camacho Wills, NP
- Women's Health Nurse Practitioner
- Orange, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Women's Health Nurse Practitioner
- License
- NP95008565
- Practice address
- 1140 W la Veta Ave Ste 770
Orange, CA 92868-4229 - Phone
- (714) 835-8715
- NPI assigned
- Aug 8, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 462152 | CA | |
| Women's Health Nurse Practitioner | 363LW0102X | NP95008565 | CA | Primary |
Addresses
Primary practice location
1140 W la Veta Ave Ste 770
Orange, CA 92868-4229
Mailing address
1140 W la Veta Ave Ste 770
Orange, CA 92868-4229
Phone (714) 835-8715
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33-0150193 | Other | CA | MEDI-CAL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1950 Sunny Crest Dr
Suite 2900
Fullerton, CA 92835-3641
Phone (714) 992-5350
2501 E Chapman Ave
Orange, CA 92869-3204
Phone (714) 633-7175
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 462152 | CA | MD | Registered Nurse |
| NP95008565 | CA | MD | Women's Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| Providence Medical Foundation | Current | Accepting new patients | |
| St. Joseph Health Northern California, LLC | Past | Accepting new patients | |
| Providence Medical Foundation | Past | Accepting new patients |
Locations
200 W Ctr St Promenade
Ste 300
Anaheim, CA 92805
Phone (714) 449-4841
101 Laguna Rd
Ste 100
Fullerton, CA 92835
100 E Valencia Mesa Dr
Ste 105
Fullerton, CA 92835
Phone (714) 446-5200
1950 Sunny Crest Dr
Ste 2900
Fullerton, CA 92835
1140 W La Veta Ave
Ste 770
Orange, CA 92868
Phone (714) 835-8715
2501 E Chapman Ave
Ste 400
Orange, CA 92869
Phone (714) 628-6642
363 S Main St
Ste 345
Orange, CA 92868
Phone (714) 835-8715
Organizations & group practices 5
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.
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- NPI 1871607762
-
- General Practice Physician
- Diamond Bar, CA
- NPI 1285890624
-
- Family Medicine Physician
- Anaheim, CA
- NPI 1639715709
-
- Hematology & Oncology Physician
- Orange, CA
- NPI 1801443510
-
- General Acute Care Hospital
- Eureka, CA
- NPI 1609858950
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1659484800000",
"number": "1326470683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1140 W LA VETA AVE STE 770",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684229",
"telephone_number": "714-835-8715"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1140 W LA VETA AVE STE 770",
"city": "ORANGE",
"state": "CA",
"postal_code": "928684229",
"telephone_number": "714-835-8715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMACHO WILLS",
"first_name": "LEEZA",
"credential": "NP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-08",
"last_updated": "2022-08-03",
"certification_date": "2022-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "CA",
"license": "462152",
"primary": false
},
{
"code": "363LW0102X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Women's Health",
"state": "CA",
"license": "NP95008565",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDI-CAL",
"identifier": "33-0150193",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Orange, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 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.