Joetta Kay Willis, M.A.

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

LMFT52986 Issued in CA

Practice address

1609 N Wilson Way
Stockton, CA 95205-3119

Phone

(209) 639-4935

NPI assigned

Sep 19, 2009

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 Arts

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: joetta.williams.p1@direct.toiyabe.nextgenshare.com
• Direct secure messaging: amirahmed.saddiqu.p1@direct.toiyabe.nextgenshare.com

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.

• Toiyabe Indian Health Project, Inc

  • Federally Qualified Health Center (FQHC)
  • Bishop, CA
  • NPI 1659433191
  NPD (past)

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

{
    "created_epoch": "1253318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1760716039",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7720 ROSEWOOD DR",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952071462",
            "telephone_number": "916-996-9736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1609 N WILSON WAY",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952053119",
            "telephone_number": "209-639-4935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIS",
        "first_name": "JOETTA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-19",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT52986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Trisha Williams
• Tyresha Williams
• Veronkia Williams
• Ernest Donell Williamson Jr.
• Willie E. Williford III
• Theodore Jim Willis III
• Carol Jeanne Willmett, LCSW
• Tyrone M Wills
• Lisa Wilson-Cash
• Avery Wilson

• Marriage & Family Therapist in Stockton, CA
• Providers in Stockton, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2017; 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.