Healthcare Provider Details

I. General information

NPI: 1154853091
Provider Name (Legal Business Name): NICOLE WILLIAMS CATC-IV, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E WASHINGTON AVE STE 200
ESCONDIDO CA
92025-1806
US

IV. Provider business mailing address

200 E WASHINGTON AVE STE 200
ESCONDIDO CA
92025-1806
US

V. Phone/Fax

Practice location:
  • Phone: 760-741-7708
  • Fax:
Mailing address:
  • Phone: 760-741-7708
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: