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NPI Code Detail

MEDICARE: SHAMONE S WILLIAMS

MEDICARE:   SHAMONE S 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
1106S00000XBehavior Technician011183127LA

General Provider Information

NPI Number : 1154073294
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAMONE S WILLIAMS
Provider Business Mailing Address
First Line : 21600 OXNARD ST STE 1800
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-7807
Country : US
Telephone Number : 818-345-2345
Fax Number :
Provider Business Practice Location Address
First Line : 1215 INDEPENDENCE BLVD BLDG 6
Second Line :
City : ZACHARY
State : LA
Zip : 70791-7390
Country : US
Telephone Number : 225-286-1547
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2022
Last Update Date : 01/20/2022

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Directions to “ SHAMONE S WILLIAMS ” Practice Location

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