Willie Harris, D.O.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

20A7769 Issued in CA

Practice address

3102 E. Highland Avenue
Medical Staff Office
Patton, CA 92369

Phone

(909) 425-7679

Fax

(909) 425-6635

NPI assigned

May 17, 2006

Sex

Male

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Department of State Hospitals

  dba Coalinga State Hospital

  • Psychiatric Hospital
  • Coalinga, CA
  • NPI 1124078704
  Medicare reassignment NPD
• Department of State Hospitals

  dba Department of State Hospitals - Patton

  • Psychiatric Hospital
  • Patton, CA
  • NPI 1043249204
  NPD
• Department of State Hospitals

  dba Department of State Hospitals-Atascadero

  • Psychiatric Hospital
  • Atascadero, CA
  • NPI 1174573802
  NPD
• Windstone Behavioral Health

  • Psychiatry Physician
  • Garden Grove, CA
  • NPI 1174607626
  NPD (past)
• Summit Pointe

  • Psychiatry Physician
  • Battle Creek, MI
  • NPI 1700833555
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390521600000",
    "number": "1477506095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3102 E. HIGHLAND AVENUE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "92369",
            "telephone_number": "909-425-7679",
            "fax_number": "909-425-6635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3102 E. HIGHLAND AVENUE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "PATTON",
            "state": "CA",
            "postal_code": "92369",
            "telephone_number": "909-425-7679",
            "fax_number": "909-425-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "WILLIE",
        "name_prefix": "Mr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2014-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "20A7769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mohamed Amr Hafez, M.D.
• David A Haimson, PH.D.
• Mohammad Hanizavareh, M.D.
• Mariam Hanna
• Kerry A Hannifin, PSY.D.
• Piyonik Hartounian, PSY.D.
• Greta Marie Herbes, M.D.
• Joshua L Horsley, M.D.
• Alexandra Hotetz
• Robbin L Huff-Musgrove, PH.D.

• Psychiatry Physician in Patton, CA
• Providers in Patton, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.