Healthcare Provider Details

I. General information

NPI: 1457274136
Provider Name (Legal Business Name): PREMIER 1ST RESPONDER PSYCHOLOGICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19361 WILLOWBROOK AVE
YORBA LINDA CA
92886-4330
US

IV. Provider business mailing address

19361 WILLOWBROOK AVE
YORBA LINDA CA
92886-4330
US

V. Phone/Fax

Practice location:
  • Phone: 714-485-3236
  • Fax: 949-246-6869
Mailing address:
  • Phone: 714-485-3236
  • Fax: 949-246-6869

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: HEATHER WILLIAMS
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 714-485-3236