Healthcare Provider Details

I. General information

NPI: 1003768946
Provider Name (Legal Business Name): KRISTINA KATARINA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2026
Last Update Date: 02/12/2026
Certification Date: 02/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8881 FLETCHER PKWY STE 250
LA MESA CA
91942-3191
US

IV. Provider business mailing address

1720 W KNAPP DR
VISTA CA
92083-1917
US

V. Phone/Fax

Practice location:
  • Phone: 714-609-0201
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95037861
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: