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General NPI Number Information
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NPI Number | 1205185964
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Entity Type | Individual
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Provider Name | EVANGELINE CHRISTINE WILLIAMS M.A.
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Gender | Female
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Dates
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Enumeration Date | 09/09/2012
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Last Update Date | 07/22/2021
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Provider Practice Location Address
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Address Line | 2116 ARLINGTON AVE STE 200
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City | LOS ANGELES
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State | CA
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Zip | 90018-1353
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Country | US
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Telephone | 949-280-0292
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2237
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City | TOLUCA LAKE
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State | CA
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Zip | 91610-0237
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Country | US
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Telephone | 949-280-0292
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Fax |
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MFTI98036
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MFTI53357
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License Number State | CA
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