Provider Demographics
NPI:1417376096
Name:WILLIAMS, NATHANIEL JR
Entity Type:Individual
Prefix:MR
First Name:NATHANIEL
Middle Name:
Last Name:WILLIAMS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 OAK ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-2217
Mailing Address - Country:US
Mailing Address - Phone:415-431-8252
Mailing Address - Fax:415-431-3195
Practice Address - Street 1:1140 OAK ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-2217
Practice Address - Country:US
Practice Address - Phone:414-431-8252
Practice Address - Fax:415-431-3195
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-10
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No302F00000XManaged Care OrganizationsExclusive Provider Organization
No344600000XTransportation ServicesTaxi
No347C00000XTransportation ServicesPrivate Vehicle
No347E00000XTransportation ServicesTransportation Broker
No385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No101Y00000XBehavioral Health & Social Service ProvidersCounselor