Healthcare Provider Details

I. General information

NPI: 1649905175
Provider Name (Legal Business Name): SUMMER LEIGH WILLIAMS LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2022
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 BARNEY RD
ANDERSON CA
96007-4301
US

IV. Provider business mailing address

1147 HARTNELL AVE
REDDING CA
96002-2113
US

V. Phone/Fax

Practice location:
  • Phone: 530-912-9523
  • Fax: 530-912-9523
Mailing address:
  • Phone: 530-222-7213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number711165
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: