Healthcare Provider Details

I. General information

NPI: 1023946514
Provider Name (Legal Business Name): KATHY KOO-YEONSU WILLIAMS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2039 CLEMENT AVE
ALAMEDA CA
94501-1317
US

IV. Provider business mailing address

2039 CLEMENT AVE
ALAMEDA CA
94501-1317
US

V. Phone/Fax

Practice location:
  • Phone: 408-892-7203
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number126548
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: