Provider Demographics
NPI:1215397864
Name:WILLS, JOSEPH BOONE III (MFT)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:BOONE
Last Name:WILLS
Suffix:III
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12144 CENTERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-8823
Mailing Address - Country:US
Mailing Address - Phone:530-521-7674
Mailing Address - Fax:
Practice Address - Street 1:6 GOVERNORS LN STE C
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926
Practice Address - Country:US
Practice Address - Phone:530-521-7674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-24
Last Update Date:2018-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA53551106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist