Healthcare Provider Details

I. General information

NPI: 1972468569
Provider Name (Legal Business Name): LAMONTE V WILLIAMS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 E 4TH ST
LONG BEACH CA
90802-1635
US

IV. Provider business mailing address

1015 E 4TH ST
LONG BEACH CA
90802-1635
US

V. Phone/Fax

Practice location:
  • Phone: 562-850-4800
  • Fax:
Mailing address:
  • Phone: 562-850-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: