MEDICARE: BRITTANI WILLIAMS LCSW

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	1041C0700X	Clinical Social Worker	LCSW83634	CA

General Provider Information

NPI Number	:	1730586314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRITTANI WILLIAMS LCSW

Provider Business Mailing Address
First Line	:	5819 ADELAIDE AVE
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92115-5420
Country	:	US
Telephone Number	:	626-374-7549
Fax Number	:

Provider Business Practice Location Address
First Line	:	4238 EL CAJON BLVD STE 226
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92105-1230
Country	:	US
Telephone Number	:	619-771-4218
Fax Number	:

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

Provider Enumeration Date	:	11/26/2014
Last Update Date	:	01/27/2021

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