Healthcare Provider Details

I. General information

NPI: 1699896365
Provider Name (Legal Business Name): RENE LEE WILLIAMSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12520 HIGH BLUFF DR SUITE 120
SAN DIEGO CA
92130-2041
US

IV. Provider business mailing address

12520 HIGH BLUFF DR SUITE 120
SAN DIEGO CA
92130-2041
US

V. Phone/Fax

Practice location:
  • Phone: 858-259-0599
  • Fax:
Mailing address:
  • Phone: 858-259-0599
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YS0200X
TaxonomySchool Counselor
License NumberPPS CREDENTIAL
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC37531
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: