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NPI Code Detail

MEDICARE: CHRISTINE WILLIAMS MA, CADA II, ICADC

MEDICARE: CHRISTINE WILLIAMS MA, CADA II, ICADC
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
1101YA0400XAddiction (Substance Use Disorder) CounselorRA8901117CA

General Provider Information

NPI Number : 1588134928
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINE WILLIAMS MA, CADA II, ICADC
Provider Business Mailing Address
First Line : 6145 IMPERIAL AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92114-4213
Country : US
Telephone Number : 817-714-6622
Fax Number : 619-234-7787
Provider Business Practice Location Address
First Line : 6145 IMPERIAL AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92114-4213
Country : US
Telephone Number : 817-714-6622
Fax Number : 619-234-7787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2018
Last Update Date : 11/28/2018

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