Healthcare Provider Details

I. General information

NPI: 1316747546
Provider Name (Legal Business Name): LINDA MICHELLE WILLIAMS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LINDA WILLIAMS RUIZ LCSW

II. Dates (important events)

Enumeration Date: 03/17/2025
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 11247
BERKELEY CA
94712-2247
US

IV. Provider business mailing address

PO BOX 11247
BERKELEY CA
94712-2247
US

V. Phone/Fax

Practice location:
  • Phone: 510-215-5001
  • Fax: 510-215-1115
Mailing address:
  • Phone: 510-215-5001
  • Fax: 510-215-1115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number123213
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: