Kathleen Anne Wills, B.A.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

35969 Issued in CA

Practice address

264 N Morrison Ave
San Jose, CA 95126-2741

Phone

(805) 890-9247

NPI assigned

Jan 16, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Mrs. Kathleen Anne Wills Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

State licenses

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

{
    "created_epoch": "1358294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1689912248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "264 N MORRISON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262741",
            "telephone_number": "805-890-9247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "264 N MORRISON AVE",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951262741",
            "telephone_number": "805-890-9247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLS",
        "first_name": "KATHLEEN",
        "middle_name": "ANNE",
        "name_prefix": "Mrs.",
        "credential": "B.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-01-16",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "35969",
            "primary": true
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "94024326",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "WILLS",
            "middle_name": "ANNE",
            "prefix": "MRS.",
            "credential": "B.A.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Willow Glen Medical Foundation
• Willow Glen Middle School
• Willow Glen Optm Physical Therapy
• Willow Glen Primary Care Medicine
• Willow Home Health Care Services, Inc
• Kate Russo Wilmot, PT
• Amy Wilson, BCBA
• Christine I.M. Wilson, NP
• Dawn Asheley Wilson
• Debra Lee Wilson, RN

• Clinical Psychologist in San Jose, CA
• Providers in San Jose, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.