Healthcare Provider Details

I. General information

NPI: 1376452680
Provider Name (Legal Business Name): THE WILL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W RIVERDALE AVE UNIT 18
ORANGE CA
92865-1054
US

IV. Provider business mailing address

101 W RIVERDALE AVE UNIT 18
ORANGE CA
92865-1054
US

V. Phone/Fax

Practice location:
  • Phone: 323-477-8766
  • Fax:
Mailing address:
  • Phone: 323-477-8766
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code167G00000X
TaxonomyLicensed Psychiatric Technician
License Number
License Number State

VIII. Authorized Official

Name: MR. ANTHONY WILLIAMS JR.
Title or Position: OWNER
Credential: L.P.T.
Phone: 323-477-8766