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CHARLES DERRELL WILLIS
NPI 1699259507
Counselor - Mental Health in Commerce, CA

Active since September 18, 2018
5650 JILLSON ST, COMMERCE, CA 90040(323) 201-4516(323) 215-0170 Get Directions Write a Review

NPPES record last updated: September 18, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Charles Derrell Willis NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHARLES DERRELL WILLIS (NPI 1699259507) is an individual mental health provider in Commerce, California and active in the NPI registry since September 2018.

NPPES Registry Identity

NPI1699259507
Entity TypeIndividualMale
Primary Taxonomy101YM0800X
Provider Legal NameCHARLES DERRELL WILLIS
Location Address5650 JILLSON STCommerce, CA 90040-1482
Mailing Address1518 N Serrano AveLos Angeles, CA 90027-4874 · (323) 536-7817
Phone(323) 201-4516
Fax(323) 215-0170
Sole ProprietorYes
Enumeration DateSeptember 18, 2018
✔ NPI 1699259507 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
5650 JILLSON ST, Commerce, CA 90040
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Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MADALENA TRUONG
Physician Assistant
5650 JILLSON ST
COMMERCE, CA 90040
Los Angeles County (213) 484-1186
BRENDA WIEWEL
Social Worker (Clinical)
5650 JILLSON ST
COMMERCE, CA 90040
Los Angeles County (323) 201-4516
ANDREA FRANKLIN
Social Worker (Clinical)
5650 JILLSON ST
COMMERCE, CA 90040
Los Angeles County (323) 201-4516
PHAEDRA ALLEN
Social Worker
5650 JILLSON ST
COMMERCE, CA 90040
Los Angeles County (323) 201-4516
EUDELINA ORTIZ JACOBO
Counselor (Mental Health)
5650 JILLSON ST
COMMERCE, CA 90040
Los Angeles County (323) 201-4516
PAAYAL BHAKTA
Pediatrics
5650 JILLSON ST
COMMERCE, CA 90040
Los Angeles County (323) 201-4516
GENEVIE KATHLEEN ESQUIVEL
Marriage & Family Therapist
5650 JILLSON ST
COMMERCE, CA 90040
Los Angeles County (213) 486-4062
MS. VANESSA ALONSO
Peer Specialist
5650 JILLSON ST
COMMERCE, CA 90040
Los Angeles County (323) 201-4516

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Charles Willis's NPI number?

The NPI number for Charles Willis is 1699259507. It was assigned to this individual provider in the NPPES registry on September 18, 2018.

Where is Charles Willis located?

Charles Willis practices at 5650 Jillson St, Commerce, CA 90040. The listed phone number is (323) 201-4516.

What is Charles Willis's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

When was this NPI record last updated?

The NPPES record for Charles Willis was last updated on September 18, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.