Provider Demographics
NPI:1154072551
Name:WILLIAMS, BELITA PAULETTE (RN)
Entity Type:Individual
Prefix:
First Name:BELITA
Middle Name:PAULETTE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7137 BANGOR AVE
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-3041
Mailing Address - Country:US
Mailing Address - Phone:209-898-5701
Mailing Address - Fax:
Practice Address - Street 1:33674 NAVAJO TRL UNIT A
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-4405
Practice Address - Country:US
Practice Address - Phone:760-517-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA777264163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty