DR. DONALD CLYDE WILLIS (NPI# 1124196423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124196423 |
| Entity Type | Individual |
| Full Name | DR. DONALD CLYDE WILLIS |
| Credential | MD |
| Practice Address |
1442 Ethan Way Ste 200 Sacramento CA 95825-2231 |
| Practice Telephone | 9164824856 |
| Practice Fax Number | 5308939347 |
| Mailing Telephone | 9164824856 |
| Mailing Fax Number | 5308939347 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2014-06-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | G35712 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00G357120 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326265398 | Donald James Willis | Social Worker | 157 U St Nw, Washington, DC 20001-1621 | 2007-04-19 |
| 1316940372 | Donald L. Willis | Urology | 1601 Redwood Rd, Ste A, San Marcos, TX 78666-1423 | 2005-05-24 |
| 1750347076 | Donald Willis | Family Medicine | 313 W Country Club Rd, Suite # 9, Roswell, NM 88201-5804 | 2006-04-25 |
| 1902870611 | Donald Clinton Willis | Obstetrics & Gynecology | 325 N State of Franklin Rd Fl 1, Johnson City, TN 37604 | 2006-02-17 |
| Street Address |
1442 ETHAN WAY STE 200 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95825-2231 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417499930 | Leah Bisogno | Registered Nurse | 1442 Ethan Way, Suite 100, Sacramento, CA 95825-2231 | 2016-11-15 |
| 1578013660 | Lisa Marche-thomas | Registered Nurse | 1442 Ethan Way, 200, Sacramento, CA 95825-2231 | 2016-10-12 |
| 1699221952 | Carol Majesky | Registered Nurse | 1442 Ethan Way, Suite 100, Sacramento, CA 95825-2232 | 2016-08-28 |
| 1265835466 | Kelly Lyon | Registered Nurse | 1442 Ethan Way, Suite 200, Sacramento, CA 95825-2231 | 2014-10-01 |
| 1306285531 | Margaret Ann Anderson | Nurse Practitioner | 1442 Ethan Way, 100, Sacramento, CA 95825-2231 | 2013-06-20 |
| 1548447378 | Chico Feminist Women's Health Center | Clinic/Center | 1442 Ethan Way, Suite 100, Sacramento, CA 95825-2231 | 2008-01-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528667854 | Sarah Claudio | Case Manager/Care Coordinator | 650 Howe Ave # 400-b, Sacramento, CA 95825 | 2020-10-19 |
| 1962009308 | Andrea Isabel Morales | Behavior Technician | 333 University Avenue, Suite 200, Sacramento, CA 95825 | 2020-10-08 |
| 1942810510 | Melissa Marlene Lowndes | Occupational Therapist | 1337 Howe Ave Unit 107, Sacramento, CA 95825 | 2020-08-07 |
| 1780294827 | Travis Elliott Peppers | Case Manager/Care Coordinator | 650 Howe Ave Suite 400-b, 650 Howe Ave Suite 400-b, Sacramento, CA 95825 | 2020-08-04 |
| 1154950327 | Hallie Wenz | Behavior Technician | 333 University Ave Suite #200, Sacramento, CA 95825 | 2020-04-08 |
| 1679105456 | Dr. Page Hudson Dental Corporation | Dentist | 1580 Howe Avenue, Suite A, Sacramento, CA 95825 | 2020-02-10 |
| 1710517891 | Amelia Garnica | Community/Behavioral Health | 720 Howe Avenue, Suite 102, Sacamento, CA 95825 | 2020-01-17 |
| 1427697374 | Anthony Barnes | Social Worker | 2008 Morse Avenue, Commons Building, Sacramento, CA 95825 | 2019-12-24 |
| 1528604519 | Mental Health America of Northern California | Community/Behavioral Health | 720 Howe Ave., Suite 102, Cacramento, CA 95825 | 2019-11-25 |
| 1164068144 | Mental Health America of Northern California | Community/Behavioral Health | 720 Howe Ave. Suite, 102, Sacramento, CA 95825 | 2019-11-25 |
| Find all providers in zip 95825 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841713732 | Wellspace Health Professional Health Center for Women | Obstetrics & Gynecology | 4150 Truxel Rd Ste C, Sacramento, CA 95834-3761 | 2017-07-21 |
| 1548716020 | Nicole Gabrielle Gomez | Obstetrics & Gynecology | 2610 O St, Apt A, Sacramento, CA 95816-6368 | 2016-08-25 |
| 1568758472 | Kathleen Ann Rooney | Obstetrics & Gynecology | 2277 Fair Oaks Blvd 355, Sacramento, CA 95825-5595 | 2011-06-20 |
| 1972814671 | Laura Elizabeth Watters | Obstetrics & Gynecology | 77 Cadillac Dr Ste 230, Sacramento, CA 95825-5480 | 2010-06-28 |
| 1285963843 | Amanda L Shepherd | Obstetrics & Gynecology | 5320 N St, Sacramento, CA 95819-4132 | 2009-12-10 |
| 1003048786 | Hailey Rose Macnear | Obstetrics & Gynecology | 2277 Fair Oaks Blvd Ste 355, Sacramento, CA 95825-5595 | 2009-08-14 |
| 1578744454 | Mala Ashok Medical Corporation | Obstetrics & Gynecology | 112 Fountain Oaks Cir, 250, Sacramento, CA 95831-3967 | 2007-11-19 |
| 1144422056 | Akiba Edo Green | Obstetrics & Gynecology | 3201 S St, 188, Sacramento, CA 95816-7078 | 2007-06-03 |
| 1801005970 | Carolyn Cupps Davis | Obstetrics & Gynecology | 2864 El Prado Way, Sacramento, CA 95825-1835 | 2007-05-22 |
| 1164643896 | Kristina Milan | Obstetrics & Gynecology | 1625 Stockton Blvd Ste 20, Sacramento, CA 95816-7097 | 2007-05-01 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95825 |
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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.