Healthcare Provider Details

I. General information

NPI: 1982480430
Provider Name (Legal Business Name): SARAH MARIE WILLIAMS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2023
Last Update Date: 08/31/2023
Certification Date: 08/31/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7250 MESA COLLEGE DR
SAN DIEGO CA
92111-4902
US

IV. Provider business mailing address

2625 KREMEYER CIR APT 11
CARLSBAD CA
92008-1635
US

V. Phone/Fax

Practice location:
  • Phone: 207-205-2905
  • Fax:
Mailing address:
  • Phone: 207-205-2905
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95026692
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number95026692
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number95026692
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: