Healthcare Provider Details

I. General information

NPI: 1386029775
Provider Name (Legal Business Name): ANGELA F. WILLIAMS, PSYD, A PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2015
Last Update Date: 07/27/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 E OLIVE AVE STE 540
BURBANK CA
91501-2132
US

IV. Provider business mailing address

17412 VENTURA BLVD STE 800
ENCINO CA
91316-3827
US

V. Phone/Fax

Practice location:
  • Phone: 818-446-2522
  • Fax:
Mailing address:
  • Phone: 310-923-1518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number23374
License Number StateCA

VIII. Authorized Official

Name: DR. ANGELA FRANCINE WILLIAMS
Title or Position: OWNER
Credential:
Phone: 310-923-1518