Provider Demographics
NPI:1275874448
Name:WILLIAMS, DOLORES ELEANOR (REGISTER NURSE)
Entity Type:Individual
Prefix:MRS
First Name:DOLORES
Middle Name:ELEANOR
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:REGISTER NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6330 RUGBY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:90255-6938
Mailing Address - Country:US
Mailing Address - Phone:323-277-7678
Mailing Address - Fax:323-277-7686
Practice Address - Street 1:6330 RUGBY AVE STE 200
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-6938
Practice Address - Country:US
Practice Address - Phone:323-277-7678
Practice Address - Fax:323-277-7686
Is Sole Proprietor?:No
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA502319163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse