Individual provider · Type 1 NPI
Lisette Willis, PMHNP
Psychiatric/Mental Health Nurse Practitioner · San Bernardino, CA
NPI number
1912833385
Active
Practice location
1805 Medical Center Dr
San Bernardino, CA 92411-1217
Mailing address
5374 Novara Ave
Fontana, CA 92336-0246
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 95039779 (CA) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1912833385
Lisette Willis, PMHNP's National Provider Identifier is 1912833385, issued on Jun 22, 2026. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in San Bernardino, CA. The record was last updated on Jun 22, 2026.