Healthcare Provider Details

I. General information

NPI: 1942155932
Provider Name (Legal Business Name): NICHOLAS WILLIAMS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 03/04/2026
Certification Date: 03/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2565 CLARK LN
WALNUT CREEK CA
94597-3042
US

IV. Provider business mailing address

2565 CLARK LN
WALNUT CREEK CA
94597-3042
US

V. Phone/Fax

Practice location:
  • Phone: 925-357-1065
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number72420
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: