Healthcare Provider Details

I. General information

NPI: 1932026689
Provider Name (Legal Business Name): MAURICE WILLIAMS MBA, BS, CHW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8629 ORCHARD BLOOM WAY
LAKESIDE CA
92040-2870
US

IV. Provider business mailing address

8629 ORCHARD BLOOM WAY
LAKESIDE CA
92040-2870
US

V. Phone/Fax

Practice location:
  • Phone: 619-980-9665
  • Fax:
Mailing address:
  • Phone: 619-980-9665
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: