Healthcare Provider Details

I. General information

NPI: 1922809763
Provider Name (Legal Business Name): DEIRDRE BETTY WILLIAMS DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

921 OAK PARK BLVD STE 101
PISMO BEACH CA
93449-3289
US

IV. Provider business mailing address

730 BEAR CANYON LN
ARROYO GRANDE CA
93420-7134
US

V. Phone/Fax

Practice location:
  • Phone: 805-473-9850
  • Fax:
Mailing address:
  • Phone: 805-441-2567
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95036497
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95220535
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: