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General NPI Number Information
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NPI Number | 1386069953
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Entity Type | Individual
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Provider Name | JEFFREY WAYNE WILLIAMS M.A., MFTI
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Gender | Male
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Dates
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Enumeration Date | 02/19/2014
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Last Update Date | 02/19/2014
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Provider Practice Location Address
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Address Line | 2121 W TEMPLE ST
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City | LOS ANGELES
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State | CA
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Zip | 90026-4915
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Country | US
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Telephone | 213-385-5100
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Fax |
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Provider Business Mailing Address
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Address Line | 2310 W 76TH ST
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City | INGLEWOOD
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State | CA
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Zip | 90305-1102
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Country | US
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Telephone | 310-654-3120
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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 | IMF70039
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License Number State | CA
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