Provider Demographics
NPI:1164607834
Name:WILLIAMS, SAMMIE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:SAMMIE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10900 183RD ST STE 105
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-5375
Mailing Address - Country:US
Mailing Address - Phone:855-530-1615
Mailing Address - Fax:562-275-8311
Practice Address - Street 1:10900 183RD ST STE 105
Practice Address - Street 2:
Practice Address - City:CERRITOS
Practice Address - State:CA
Practice Address - Zip Code:90703-5375
Practice Address - Country:US
Practice Address - Phone:855-530-1615
Practice Address - Fax:562-275-8311
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-31
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY23568103T00000X
103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist