MEDICARE: TERRI WILLIAMS RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WX0106X	Occupational Health Registered Nurse	387338	CA

General Provider Information

NPI Number	:	1033571369
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI WILLIAMS RN

Provider Business Mailing Address
First Line	:	25 SETON RD
Second Line	:
City	:	IRVINE
State	:	CA
Zip	:	92612-2130
Country	:	US
Telephone Number	:	949-282-7195
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 W SANTA ANA BLVD
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92701-4558
Country	:	US
Telephone Number	:	714-565-3783
Fax Number	:	714-565-3788

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2016
Last Update Date	:	03/25/2016

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