Provider Demographics
NPI:1033529235
Name:WILLIAMS, KIRVIA JOSEFINA (DO)
Entity Type:Individual
Prefix:
First Name:KIRVIA
Middle Name:JOSEFINA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DO
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Other - Credentials:
Mailing Address - Street 1:1180 N INDIAN CANYON DR STE W214
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-4857
Mailing Address - Country:US
Mailing Address - Phone:760-416-4543
Mailing Address - Fax:760-416-4543
Practice Address - Street 1:1180 N INDIAN CANYON DR STE W214
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-4857
Practice Address - Country:US
Practice Address - Phone:760-416-4543
Practice Address - Fax:760-416-4543
Is Sole Proprietor?:No
Enumeration Date:2014-04-28
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA149362084V0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA14936OtherCA LICENSE