Healthcare Provider Details

I. General information

NPI: 1831028745
Provider Name (Legal Business Name): ANDREA VICTORIA WILLIAMS PSY.D., L.E.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2026
Last Update Date: 05/16/2026
Certification Date: 05/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9214 CROSSCOURT WAY
ELK GROVE CA
95624-3919
US

IV. Provider business mailing address

9214 CROSSCOURT WAY
ELK GROVE CA
95624-3919
US

V. Phone/Fax

Practice location:
  • Phone: 951-751-2132
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License NumberLEP4361
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: