Healthcare Provider Details

I. General information

NPI: 1710468590
Provider Name (Legal Business Name): TRISH V WILLIAMS-FORDE DNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5901 W CENTURY BLVD STE 750
LOS ANGELES CA
90045-5443
US

IV. Provider business mailing address

5901 W CENTURY BLVD STE 750
LOS ANGELES CA
90045-5443
US

V. Phone/Fax

Practice location:
  • Phone: 424-248-1182
  • Fax: 424-757-9693
Mailing address:
  • Phone: 424-248-1182
  • Fax: 424-757-9693

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number95019273
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number829012
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: