Healthcare Provider Details

I. General information

NPI: 1689562068
Provider Name (Legal Business Name): ELIZABETH WILLIAMS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2025
Last Update Date: 06/25/2025
Certification Date: 06/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

62931 LOFTWOOD ST
DESERT HOT SPRINGS CA
92240-2063
US

IV. Provider business mailing address

62931 LOFTWOOD ST
DESERT HOT SPRINGS CA
92240-2063
US

V. Phone/Fax

Practice location:
  • Phone: 760-219-0817
  • Fax:
Mailing address:
  • Phone: 760-219-0817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number557086
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code163WI0500X
TaxonomyInfusion Therapy Registered Nurse
License Number557086
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: