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NPI Code Detail

MEDICARE: WILLIAM WALTER HARRIS

MEDICARE: WILLIAM WALTER HARRIS
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
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1750574596
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM WALTER HARRIS
Provider Business Mailing Address
First Line : 68615 PEREZ RD
Second Line : SUITE 2A
City : CATHEDRAL CITY
State : CA
Zip : 92234-7200
Country : US
Telephone Number : 760-770-2267
Fax Number : 760-770-2240
Provider Business Practice Location Address
First Line : 14320 PALM DR
Second Line :
City : DESERT HOT SPRINGS
State : CA
Zip : 92240-6874
Country : US
Telephone Number : 951-955-3306
Fax Number : 760-770-2250
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2007
Last Update Date : 03/05/2019

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