Willis, Randee Denice

Willis, Randee Denice is an individual health care provider with primary practice located at 23456 Hawthorne Blvd Ste 100 , Torrance CA 90505-4752. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Willis, Randee Denice can be contacted via phone (310) 540-5272.

Contact Information

Primary practice address
23456 Hawthorne Blvd Ste 100 Torrance CA 90505-4752
Phone: (310) 540-5272
Fax: (310) 540-7271
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 13139PA California

Profile Details

NPI number 1073618260
LBN Legal business name Willis, Randee Denice
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 13th, 2006
Last updated Oct 29th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073618260 NPPES
California Other 13139PA STATE LICENSE NUMBER

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