KYSON WILLIS (NPI# 1073148169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073148169 |
| Entity Type | Individual |
| Full Name | KYSON WILLIS |
| Practice Address |
1400 N Norma St Ste 127-133 Ridgecrest CA 93555-2575 |
| Practice Telephone | 7604997406 |
| Mailing Telephone | 7604997406 |
| Enumeration Date | 2020-03-09 |
| Last Update Date | 2020-03-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
1400 N NORMA ST STE 127-133 |
| City | RIDGECREST |
| State | CA |
| Zip Code | 93555-2575 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427172899 | Debbie Diane Beckett | Counselor | 1400 N Norma St Ste 127-133, Ridgecrest, CA 93555-2575 | 2007-03-19 |
| 1497372643 | Jessica Hiatt | Case Manager/Care Coordinator | 1400 N Norma St Ste 127-133, Ridgecrest, CA 93555-2575 | 2020-07-02 |
| 1962023499 | Joshua Ray Pierce | Peer Specialist | 1400 N Norma St Ste 127-133, Ridgecrest, CA 93555-2575 | 2020-05-06 |
| 1851866321 | Lacinda Beyes | Case Manager/Care Coordinator | 1400 N Norma St Ste 127-133, Ridgecrest, CA 93555-2575 | 2018-10-10 |
| 1720489065 | Venecia Ebneof | Counselor | 1400 N Norma St Ste 127-133, Ridgecrest, CA 93555 | 2014-09-05 |
| 1558798769 | Ashley Lynn Pascarella | Case Manager/Care Coordinator | 1400 N Norma St Ste 127-133, Ridgecrest, CA 93555-2575 | 2013-10-02 |
| 1225241417 | College Community Services | Community/Behavioral Health | 1400 N Norma St Ste 127-133, Ridgecrest, CA 93555-2575 | 2007-05-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321776 | Patrick Joseph Mccammon | Case Manager/Care Coordinator | 1400 N Norma, Ste 127, Ridgecrest, CA 93555 | 2019-11-25 |
| 1780170704 | Krista Mae Sanchez Tizon | Behavior Technician | 123 Grande Way, Suite B, Ridgecrest, CA 93555 | 2018-07-02 |
| 1245726348 | Shinta Desentia Fraya | Behavior Technician | 123 Grande Way Ste B, Ridgecrest, CA 93555 | 2018-07-02 |
| 1780114397 | Darci Turner | Occupational Therapy Assistant | 4309 W Weiman, Ridgecrest, CA 93555 | 2017-06-15 |
| 1700319407 | Telecare Corporation | Clinic/Center | 1141 Chelsea Street, Ridgecrest, CA 93555 | 2017-04-10 |
| 1245776236 | Katherine Gerow | Prevention Professional | 1131 Inyokern Rd, Ridgecrest, CA 93555 | 2017-01-13 |
| 1639552151 | Max Scott Higa | Social Worker | 1400 North Norma Street, Suite 133, Ridgecrest, CA 93555 | 2015-07-01 |
| 1184044703 | Ridgecrest Charter School | Speech-Language Pathologist | 325 S. Downs St., Ridgecrest, CA 93555 | 2014-04-22 |
| 1023366838 | Andrew Whalley | Occupational Therapist | 901 N.heritage Dr., Suite 106, Ridgecrest, CA 93555 | 2012-08-28 |
| 1831453026 | Andrew S Peters | Family Medicine | 1 Administration Circle, Stop 1311, Branch Clinic China Lake, Bldg 1403, Ridgecrest, CA 93555 | 2012-07-02 |
| Find all providers in zip 93555 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790321776 | Patrick Joseph Mccammon | Case Manager/Care Coordinator | 1400 N Norma, Ste 127, Ridgecrest, CA 93555 | 2019-11-25 |
| 1750877684 | Ryan Hunter Mcamis | Case Manager/Care Coordinator | 1400 N Norma St Ste 137, Ridgecrest, CA 93555-2577 | 2018-07-03 |
| 1184954489 | Cheryl Ann Bradley | Case Manager/Care Coordinator | 701 South Inyokern Ridgecrest, Ridgecrest, CA 93555-2577 | 2010-01-08 |
| 1265617427 | Maria Eleazar Brooks | Case Manager/Care Coordinator | 825 N Downs St, Suite A, Ridgecrest, CA 93555-3371 | 2008-01-07 |
| 1114070760 | Ruthy Michele Smith | Case Manager/Care Coordinator | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2007-01-18 |
| 1346391117 | Kari Aletha Bilson | Case Manager/Care Coordinator | 825 N Downs St Ste A, Ridgecrest, CA 93555-3371 | 2007-01-16 |
| 1497372643 | Jessica Hiatt | Case Manager/Care Coordinator | 1400 N Norma St Ste 127-133, Ridgecrest, CA 93555-2575 | 2020-07-02 |
| 1033759808 | Vicki Leanne Elliott | Case Manager/Care Coordinator | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2020-01-09 |
| 1730729526 | Samantha Hirsch | Case Manager/Care Coordinator | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2020-01-09 |
| 1578109096 | Whitney Lee Haefele | Case Manager/Care Coordinator | 1400 N Norma St Ste 133, Ridgecrest, CA 93555-2577 | 2019-11-19 |
| Find all providers in RIDGECREST | ||||
| City | RIDGECREST |
| Zip Code | 93555 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.