Healthcare Provider Details

I. General information

NPI: 1689088239
Provider Name (Legal Business Name): MONIQUE WILLIAMS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 OAK ST
SAN FRANCISCO CA
94117-2217
US

IV. Provider business mailing address

887 POTRERO AVE
SAN FRANCISCO CA
94110-2869
US

V. Phone/Fax

Practice location:
  • Phone: 415-431-8252
  • Fax: 415-431-3195
Mailing address:
  • Phone: 628-206-2855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code373H00000X
TaxonomyDay Training/Habilitation Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: