Callie Wilmore, M.S.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

18989 Issued in CA

Practice address

1149 W 190TH St Ste 2300
Gardena, CA 90248-4350

Phone

(310) 892-5812

NPI assigned

Mar 21, 2024

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1710979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1396505731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 MANHATTAN AVE APT 2",
            "city": "HERMOSA BEACH",
            "state": "CA",
            "postal_code": "902545133",
            "telephone_number": "901-413-1307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1149 W 190TH ST STE 2300",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902484350",
            "telephone_number": "310-892-5812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMORE",
        "first_name": "CALLIE",
        "name_prefix": "Ms.",
        "credential": "M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-03-21",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "18989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie Ellen Williamson
• Joneise Willis
• Lauren Willis, R.N., M.S.N., P.H.N.
• Namari Willis
• Valerie Willis
• Christopher Mark Wilmoth
• Kaynia Korlette Wilson
• Kyle Wilson
• Nina Wilson
• Brandy Nichole Wilt, NP

• Speech-Language Pathologist in Gardena, CA
• Providers in Gardena, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; 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.