MEDICARE: MOIRA HELENA WILLIAMS

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	1041C0700X	Clinical Social Worker	LCSW123154	CA

General Provider Information

NPI Number	:	1215304134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MOIRA HELENA WILLIAMS

Provider Business Mailing Address
First Line	:	6160 CORNERSTONE CT E
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3720
Country	:	US
Telephone Number	:	858-216-8837
Fax Number	:	888-383-0040

Provider Business Practice Location Address
First Line	:	6160 CORNERSTONE CT E
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92121-3720
Country	:	US
Telephone Number	:	858-216-8837
Fax Number	:	888-383-0040

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

Provider Enumeration Date	:	08/26/2015
Last Update Date	:	12/09/2025

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