KIMBERLY NICHELLE WILLIS
NPI 1992201115
Community Health Worker in Lynwood, CA

Active since April 05, 2018
2640 INDUSTRY WAY, LYNWOOD, CA 90262(310) 627-4525 Get Directions Write a Review

NPPES record last updated: May 21, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Kimberly Nichelle Willis NPPES

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

KIMBERLY NICHELLE WILLIS (NPI 1992201115) is an individual community health worker in Lynwood, California and active in the NPI registry since April 2018. She maintains a secondary practice location in Long Beach.

NPPES Registry Identity

NPI1992201115
Entity TypeIndividualFemale
Primary Taxonomy172V00000X
Provider Legal NameKIMBERLY NICHELLE WILLIS
Location Address2640 INDUSTRY WAYLynwood, CA 90262-4284
Mailing Address2640 Industry WayLynwood, CA 90262-4284 · (323) 751-3026
Sole ProprietorYes
Enumeration DateApril 5, 2018
Last NPPES UpdateMay 21, 2025
NPPES CertifiedMay 21, 2025
NPI 1992201115 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

Primary SpecialtyCommunity Health WorkerOther Service Providers
Taxonomy Code172V00000X
Definition
Community health workers (CHW) are lay members of communities who work either for pay or as volunteers in association with the local health care system in both urban and rural environments and usually share ethnicity, language, socioeconomic status and life experiences with the community members they serve. They have been identified by many titles such as community health advisors, lay health advocates, promotores(as), outreach educators, community health representatives, peer health promoters, and peer health educators. CHWs offer interpretation and translation services, provide culturally appropriate health education and information, assist people in receiving the care they need, give informal counseling and guidance on health behaviors, advocate for individual and community health needs, and provide some direct services such as first aid and blood pressure screening. Some examples of these practitioners are Community Health Aides or Practitioners established under 25 USC 1616 (l) under HHS, Indian Health Service, Public Health Service.
Also ListedCase Manager/Care CoordinatorTaxonomy 171M00000X
Also ListedRehabilitation PractitionerTaxonomy 225400000X
Also ListedDay Training/Habilitation SpecialistTaxonomy 373H00000X
2640 INDUSTRY WAY, Lynwood, CA 90262

Secondary Practice Location 1

Location 11501 Hughes Way Ste 150Long Beach, CA 90810-1878 · Phone (310) 221-6336

Other Providers at the Same Location NPPES 20

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

Rehabilitation Practitioner
2640 INDUSTRY WAY
LYNWOOD, CA 90262
Social Worker
2640 INDUSTRY WAY, SUITE B
LYNWOOD, CA 90262
Marriage & Family Therapist
2640 INDUSTRY WAY
LYNWOOD, CA 90262
Rehabilitation Practitioner
2640 INDUSTRY WAY
LYNWOOD, CA 90262
Nurse Practitioner (Psychiatric/Mental Health)
2640 INDUSTRY WAY
LYNWOOD, CA 90262
Social Worker (Clinical)
2640 INDUSTRY WAY
LYNWOOD, CA 90262
Rehabilitation Practitioner
2640 INDUSTRY WAY
LYNWOOD, CA 90262
Licensed Vocational Nurse
2640 INDUSTRY WAY
LYNWOOD, CA 90262

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 Kimberly Willis's NPI number?

The NPI number for Kimberly Willis is 1992201115. It was assigned to this individual provider in the NPPES registry on April 5, 2018.

Where is Kimberly Willis located?

Kimberly Willis practices at 2640 Industry Way, Lynwood, CA 90262. The listed phone number is (310) 627-4525.

What is Kimberly Willis's specialty?

The primary specialty registered for this NPI is Community Health Worker with taxonomy code 172V00000X.

When was this NPI record last updated?

The NPPES record for Kimberly Willis was last updated on May 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 months 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.