Healthcare Provider Details

I. General information

NPI: 1730227539
Provider Name (Legal Business Name): KRISTEN NOELLE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2007
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4636 W 132ND ST
HAWTHORNE CA
90250-5115
US

IV. Provider business mailing address

4636 W 132ND ST
HAWTHORNE CA
90250-5115
US

V. Phone/Fax

Practice location:
  • Phone: 424-200-0272
  • Fax:
Mailing address:
  • Phone: 424-200-0272
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number39473
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: