Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Charles Derrell Willis

Individual provider Mental Health Counselor · NPI 1699259507

Charles Derrell Willis is a Mental Health Counselor in Commerce, California. Practices as a sole proprietor. Registered with an NPI since 2018.

In the registry since
2018
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Practice location Address checks out

5650 Jillson St
Commerce, CA 90040-1482
Phone: (323) 201-4516
Fax: (323) 215-0170
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X

Record details

NPI number1699259507
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedSeptember 18, 2018
Last updated in NPPESSeptember 18, 2018
Mailing address1518 N Serrano Ave, Los Angeles, CA 90027-4874

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