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NPI Code Detail

MEDICARE: CHANDRA MONIQUE WILLIAMS

MEDICARE: CHANDRA 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
11041C0700XClinical Social WorkerLCS17092CA

General Provider Information

NPI Number : 1437297843
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHANDRA MONIQUE WILLIAMS
Provider Business Mailing Address
First Line : 2640 INDUSTRY WAY
Second Line :
City : LYNWOOD
State : CA
Zip : 90262-4284
Country : US
Telephone Number : 310-627-4525
Fax Number :
Provider Business Practice Location Address
First Line : 3850 CRENSHAW BLVD
Second Line :
City : LOS ANGELES
State : CA
Zip : 90008-1821
Country : US
Telephone Number : 323-751-3026
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2007
Last Update Date : 01/14/2022

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Directions to “ CHANDRA MONIQUE WILLIAMS ” Practice Location

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