MEDICARE: JULIET WILLIAMS CRNA

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	367500000X	Certified Registered Nurse Anesthetist	95000474	CA

General Provider Information

NPI Number	:	1811356272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIET WILLIAMS CRNA

Provider Business Mailing Address
First Line	:	1 PASEO VECINO
Second Line	:
City	:	RANCHO SANTA MARGARITA
State	:	CA
Zip	:	92688
Country	:	US
Telephone Number	:	928-848-0186
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 PASEO VECINO
Second Line	:
City	:	RANCHO SANTA MARGARITA
State	:	CA
Zip	:	92688-3874
Country	:	US
Telephone Number	:	928-848-0186
Fax Number	:

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

Provider Enumeration Date	:	02/15/2016
Last Update Date	:	02/15/2016

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