Healthcare Provider Details

I. General information

NPI: 1588961627
Provider Name (Legal Business Name): FELICIA B WILLIAMS N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2011
Last Update Date: 02/13/2025
Certification Date: 02/13/2025
Deactivation Date: 10/18/2018
Reactivation Date: 10/31/2018

III. Provider practice location address

38345 30TH ST E STE F1
PALMDALE CA
93550-4985
US

IV. Provider business mailing address

38345 30TH ST E STE F1
PALMDALE CA
93550-4985
US

V. Phone/Fax

Practice location:
  • Phone: 661-538-1075
  • Fax: 661-526-5001
Mailing address:
  • Phone: 661-538-1075
  • Fax: 661-526-5001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number20377
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number20377
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: