Provider Demographics
NPI:1114054509
Name:WILLIAMS, CHARLES (CAS II)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:CAS II
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41017 ARRON CT
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-6003
Mailing Address - Country:US
Mailing Address - Phone:951-380-9551
Mailing Address - Fax:951-696-9783
Practice Address - Street 1:41017 ARRON CT
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-6003
Practice Address - Country:US
Practice Address - Phone:951-380-9551
Practice Address - Fax:951-696-9783
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-27
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)