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General NPI Number Information
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NPI Number | 1154849933
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Entity Type | Individual
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Provider Name | CAMILLA RUTH WILLIAMS PH.D.
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Gender | Female
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Dates
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Enumeration Date | 08/31/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 15525 POMERADO RD STE C5
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City | POWAY
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State | CA
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Zip | 92064-2426
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Country | US
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Telephone | 619-403-5578
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Fax | 886-273-9073
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Provider Business Mailing Address
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Address Line | 15525 POMERADO RD STE C5
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City | POWAY
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State | CA
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Zip | 92064-2426
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Country | US
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Telephone | 619-403-5578
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Fax | 886-273-9073
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PSY27200
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License Number State | CA
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