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General NPI Number Information
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NPI Number | 1235963810
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Entity Type | Individual
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Provider Name | THALIA WILLIAMS
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Gender | Female
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Dates
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Enumeration Date | 08/27/2024
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 3450 3RD ST STE 1C
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City | SAN FRANCISCO
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State | CA
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Zip | 94124-1444
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Country | US
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Telephone | 415-437-3990
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Fax |
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Provider Business Mailing Address
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Address Line | 386 GOODWIN DR
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City | SAN BRUNO
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State | CA
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Zip | 94066-1669
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Country | US
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Telephone | 559-213-9622
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 17502
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 149000
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License Number State | CA
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