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

Kimberly Nichelle Willis

Individual provider Rehabilitation Practitioner · NPI 1992201115

Kimberly Nichelle Willis is a Rehabilitation Practitioner in Lynwood, California. Practices as a sole proprietor and works from 2 locations. Licensed in California.

Licensed in
CA
In the registry since
2018
Specialties on file
4

Practice location Address checks out

2640 Industry Way
Lynwood, CA 90262-4284
Phone: (310) 627-4525
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1501 Hughes Way Ste 150, Long Beach, CA 90810-1878 — (310) 221-6336

Specialties & licences

Community Health Worker (primary) Taxonomy 172V00000X
Rehabilitation Practitioner Taxonomy 225400000X (CA)
Case Manager/Care Coordinator Taxonomy 171M00000X
Day Training/Habilitation Specialist Taxonomy 373H00000X

Record details

NPI number1992201115
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedApril 5, 2018
Last updated in NPPESMay 21, 2025
Certification dateMay 21, 2025
Mailing address2640 Industry Way, Lynwood, CA 90262-4284

Other providers in Lynwood