MISS KATHY RENEE WILLIS
NPI 1932476611
Respite Care - Respite Care, Mental Illness, Child in Mesa, AZ

Q: What is Kathy Willis's NPI number?

The NPI number for Kathy Willis is 1932476611. It was assigned to this individual provider in the NPPES registry on November 22, 2011.

Q: What is Kathy Willis's specialty?

The primary specialty registered for this NPI is Respite Care, specializing in Respite Care, Mental Illness, Child, with taxonomy code 385HR2055X.

Q: When was this NPI record last updated?

The NPPES record for Kathy Willis was last updated on August 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since November 22, 2011

11026 E SEGURA AVE, MESA, AZ 85212(480) 235-9107 Get Directions Write a Review

NPPES record last updated: August 17, 2020. Verified against the NPPES registry weekly; last sync: September 06, 2026.

On this page

About Miss Kathy Renee Willis NPPES

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

MISS KATHY RENEE WILLIS (NPI 1932476611) is an individual respite care, mental illness, child provider in Mesa, Arizona, licensed in Arizona (3162012) and active in the NPI registry since November 2011. She maintains a secondary practice location in Phoenix.

NPPES Registry Identity

NPI1932476611

Entity TypeIndividualFemale

Primary Taxonomy385HR2055X

Provider Legal NameMISS KATHY RENEE WILLIS

Location Address11026 E SEGURA AVEMesa, AZ 85212-5214

Mailing Address11026 E Segura AveMesa, AZ 85212-5214

Phone(480) 235-9107

Sole ProprietorYes

Enumeration DateNovember 22, 2011

Last NPPES UpdateAugust 17, 2020

NPPES CertifiedAugust 17, 2020

✔ NPI 1932476611 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRespite Care · Respite Care, Mental Illness, ChildRespite Care Facility

Taxonomy Code385HR2055X

License✔ Licensed in AZ · 3162012

Definition

A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers.

Also ListedSocial WorkerTaxonomy 104100000X · License 3162012 (AZ)

11026 E SEGURA AVE, Mesa, AZ 85212

Open in Google Maps ↗

Secondary Practice Location 1

Location 12320 W Peoria Ave Ste C111Phoenix, AZ 85029-4715 · Phone (602) 283-7100

Other Identifiers 1

Other3162012AZ · Az Dept Of Health Services

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 Kathy Willis's NPI number?

The NPI number for Kathy Willis is 1932476611. It was assigned to this individual provider in the NPPES registry on November 22, 2011.

Where is Kathy Willis located?

Kathy Willis practices at 11026 E Segura Ave, Mesa, AZ 85212. The listed phone number is (480) 235-9107.

What is Kathy Willis's specialty?

The primary specialty registered for this NPI is Respite Care, specializing in Respite Care, Mental Illness, Child, with taxonomy code 385HR2055X.

When was this NPI record last updated?

The NPPES record for Kathy Willis was last updated on August 17, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.