MEDICARE: ERICA WILLIAMS M.S.

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
1	103K00000X	Behavior Analyst	1-11-8192	CA

General Provider Information

NPI Number	:	1699125583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERICA WILLIAMS M.S.

Provider Business Mailing Address
First Line	:	3424 ROCKHAMPTON DR
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93012-7735
Country	:	US
Telephone Number	:	818-489-1104
Fax Number	:

Provider Business Practice Location Address
First Line	:	3424 ROCKHAMPTON DR
Second Line	:
City	:	CAMARILLO
State	:	CA
Zip	:	93012-7735
Country	:	US
Telephone Number	:	818-489-1104
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2016
Last Update Date	:	06/21/2016

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