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NPI Code Detail

MEDICARE: KERENE MONIQUE WILLIAMS

MEDICARE: KERENE MONIQUE WILLIAMS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164X00000XLicensed Vocational Nurse740971CA

General Provider Information

NPI Number : 1033047469
Entity Type Code : Individual
Provider Name (Legal Business Name) : KERENE MONIQUE WILLIAMS
Provider Business Mailing Address
First Line : 661 GRANITE LN
Second Line :
City : FAIRFIELD
State : CA
Zip : 94534-4152
Country : US
Telephone Number : 563-594-7451
Fax Number :
Provider Business Practice Location Address
First Line : 2101 COURAGE DR
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-6717
Country : US
Telephone Number : 707-428-1131
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2026
Last Update Date : 05/13/2026

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