Healthcare Provider Details

I. General information

NPI: 1699596171
Provider Name (Legal Business Name): KATHERINE WILLIAMS NMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2024
Last Update Date: 10/17/2024
Certification Date: 10/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W IVY ST STE A
SAN DIEGO CA
92101-1771
US

IV. Provider business mailing address

5395 NAPA ST APT 135
SAN DIEGO CA
92110-2654
US

V. Phone/Fax

Practice location:
  • Phone: 619-840-6700
  • Fax:
Mailing address:
  • Phone: 406-750-7419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License NumberND1514
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: