Healthcare Provider Details

I. General information

NPI: 1316346224
Provider Name (Legal Business Name): KIRSTEN MARIE MCWILLIAMS AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2014
Last Update Date: 03/15/2024
Certification Date: 03/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 UNIVERSITY AVE
SACRAMENTO CA
95825-6708
US

IV. Provider business mailing address

650 UNIVERSITY AVE STE 108
SACRAMENTO CA
95825-6726
US

V. Phone/Fax

Practice location:
  • Phone: 916-646-2471
  • Fax: 916-646-2472
Mailing address:
  • Phone: 166-462-4719
  • Fax: 916-646-2472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License NumberAU3368
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: