Healthcare Provider Details

I. General information

NPI: 1770102014
Provider Name (Legal Business Name): MARY HOWLAND WILLIAMSON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2020
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 GREEN VALLEY RD
FREEDOM CA
95019-3160
US

IV. Provider business mailing address

2907 CHANTICLEER AVE
SANTA CRUZ CA
95065-1815
US

V. Phone/Fax

Practice location:
  • Phone: 831-458-5865
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberA206967
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: