Provider Demographics
NPI:1083116651
Name:WILLIAMS, LAURA KATHLEEN (PSY D)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:KATHLEEN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PSY D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 MORAGA RD STE 215
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4562
Mailing Address - Country:US
Mailing Address - Phone:925-586-9784
Mailing Address - Fax:925-377-0982
Practice Address - Street 1:935 MORAGA RD STE 215
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4562
Practice Address - Country:US
Practice Address - Phone:925-586-9784
Practice Address - Fax:925-377-0982
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20169103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist