Healthcare Provider Details

I. General information

NPI: 1114564101
Provider Name (Legal Business Name): ANA CELINA WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2019
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5530 OVERLAND AVE
SAN DIEGO CA
92123-1260
US

IV. Provider business mailing address

5530 OVERLAND AVE STE 150
SAN DIEGO CA
92123-1261
US

V. Phone/Fax

Practice location:
  • Phone: 619-528-4000
  • Fax: 858-514-6514
Mailing address:
  • Phone: 619-528-4000
  • Fax: 858-514-6514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberRN95216703
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: