Provider Demographics
NPI:1275030439
Name:WILLIAMS, ROBYN RAYE
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:RAYE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1153 REGENT ST APT A
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-5330
Mailing Address - Country:US
Mailing Address - Phone:501-205-9746
Mailing Address - Fax:
Practice Address - Street 1:1153 REGENT ST APT A
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-5330
Practice Address - Country:US
Practice Address - Phone:510-205-9746
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-12
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty