Healthcare Provider Details

I. General information

NPI: 1013760545
Provider Name (Legal Business Name): HEATHER LEANN WILLIAMS MA, AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2024
Last Update Date: 04/05/2024
Certification Date: 04/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 TIPTON TER
LOS ANGELES CA
90042-1253
US

IV. Provider business mailing address

500 S LOS ROBLES AVE APT 303
PASADENA CA
91101-3208
US

V. Phone/Fax

Practice location:
  • Phone: 805-558-8649
  • Fax:
Mailing address:
  • Phone: 805-558-8649
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberAMFT145347
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: