Individual provider · Type 1 NPI

Charles Derrell Willis

Mental Health Counselor · Commerce, CA

NPI number 1699259507 Active

Practice location

5650 Jillson St
Commerce, CA 90040-1482

Call (323) 201-4516 Map

Fax (323) 215-0170

Mailing address

1518 N Serrano Ave
Los Angeles, CA 90027-4874

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1699259507

Charles Derrell Willis's National Provider Identifier is 1699259507, issued on Sep 18, 2018. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Commerce, CA. The record was last updated on Sep 18, 2018.