Jenica Marissa Willis, LM, CPM, LVN, IBCLC
Midwife in Bakersfield, CA. Individual provider (NPI-1).
NPI number1962099804
StatusActive
Last updated in NPPESMar 15, 2025
Details
- NPI
- 1962099804
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Jenica Marissa Willis
- Credential
- LM, CPM, LVN, IBCLC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 27, 2020
- Certification date
- Mar 15, 2025
- Last updated
- Mar 15, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 176B00000X | Midwife | LM764 | CA | Yes |
| 164X00000X | Licensed Vocational Nurse | 286953 | CA | |
| 174N00000X | Lactation Consultant, Non-RN | L-302379 | CA |
Practice location
1031 17th StreetBakersfield, CA 93301-6172
Phone 661-234-9894 · Fax 661-360-6243
Mailing address
1031 17th StreetBakersfield, CA 93301
Phone 661-234-9894 · Fax 661-360-6243
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