Healthcare Provider Details

I. General information

NPI: 1386592889
Provider Name (Legal Business Name): SHIREEN ANTOINETTE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

516 W ESTHER ST
LONG BEACH CA
90813-1529
US

IV. Provider business mailing address

378 E HILLSDALE ST APT A
INGLEWOOD CA
90302-6265
US

V. Phone/Fax

Practice location:
  • Phone: 562-506-7553
  • Fax:
Mailing address:
  • Phone: 213-909-1891
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberBACB760934
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: