Jermaine L Willis

Primary specialty

Behavior AnalystTaxonomy code 103K00000X

Practice address

225 W Hospitality LN Ste 201H
San Bernardino, CA 92408-3245

Phone

(951) 446-7417

NPI assigned

Jul 31, 2018

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1532995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532995200000",
    "number": "1679051890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9592 7TH ST",
            "city": "RANCHO CUCAMONGA",
            "state": "CA",
            "postal_code": "917305609",
            "telephone_number": "951-376-0354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 W HOSPITALITY LN STE 201H",
            "city": "SAN BERNARDINO",
            "state": "CA",
            "postal_code": "924083245",
            "telephone_number": "951-446-7417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "JERMAINE",
        "middle_name": "L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-31",
        "last_updated": "2018-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Williamsen, PHARM.D.
• Toya Williamson
• Amarri Willis
• Amy Marie Willis
• Fontaine Willis
• Lisette Willis, PMHNP
• Monique Renee Willis
• Wilshiremed Center Inc
• Wilson Dentistry, Inc.
• Wilson Gomer M.D. Professional Medical Corporation

• Behavior Analyst in San Bernardino, CA
• Providers in San Bernardino, CA by specialty
• Behavior Analyst in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2018; 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.