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NPI Code Detail

MEDICARE: MS. CHRISTINE LYNN WILLIAMSON LMFT

MEDICARE: MS. CHRISTINE LYNN WILLIAMSON LMFT
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
1106H00000XMarriage & Family TherapistMFC 40931CA

General Provider Information

NPI Number : 1306972930
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHRISTINE LYNN WILLIAMSON LMFT
Provider Business Mailing Address
First Line : 4740 N GRAND AVE
Second Line :
City : COVINA
State : CA
Zip : 91724-3853
Country : US
Telephone Number : 626-859-2089
Fax Number : 626-859-6537
Provider Business Practice Location Address
First Line : 4740 N GRAND AVE
Second Line :
City : COVINA
State : CA
Zip : 91724-3853
Country : US
Telephone Number : 626-859-2089
Fax Number : 626-859-6537
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2007
Last Update Date : 10/06/2011

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