Healthcare Provider Details

I. General information

NPI: 1336304476
Provider Name (Legal Business Name): ANGEL ANN WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2008
Last Update Date: 07/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 N MAIN ST
ALTURAS CA
96101-3496
US

IV. Provider business mailing address

441 N MAIN ST
ALTURAS CA
96101-3496
US

V. Phone/Fax

Practice location:
  • Phone: 530-233-6312
  • Fax: 530-233-6339
Mailing address:
  • Phone: 530-233-6312
  • Fax: 530-233-6339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: