Healthcare Provider Details

I. General information

NPI: 1336580505
Provider Name (Legal Business Name): WANDA YVETTE WILLIAMS APCC, AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2013
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 E COOLEY DR STE B2
COLTON CA
92324-3959
US

IV. Provider business mailing address

25910 ACERO STE 160
MISSION VIEJO CA
92691-2777
US

V. Phone/Fax

Practice location:
  • Phone: 909-572-3154
  • Fax:
Mailing address:
  • Phone: 877-527-7227
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number9195
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number135274
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: