Healthcare Provider Details

I. General information

NPI: 1679982698
Provider Name (Legal Business Name): ANGELINA WILLIAMS PHARM D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2014
Last Update Date: 07/13/2026
Certification Date: 07/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 MARSHALL WAY
PLACERVILLE CA
95667-6533
US

IV. Provider business mailing address

1100 MARSHALL WAY
PLACERVILLE CA
95667-6533
US

V. Phone/Fax

Practice location:
  • Phone: 530-626-2986
  • Fax:
Mailing address:
  • Phone: 530-626-2986
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number70727
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: