Provider Demographics
NPI:1437142650
Name:WILLIAMS, TITIMA LIN (DC)
Entity Type:Individual
Prefix:DR
First Name:TITIMA
Middle Name:LIN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3022 W AVENUE L
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93536-4036
Mailing Address - Country:US
Mailing Address - Phone:661-722-8183
Mailing Address - Fax:661-722-7897
Practice Address - Street 1:3022 W AVENUE L
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93536-4036
Practice Address - Country:US
Practice Address - Phone:661-722-8183
Practice Address - Fax:661-722-7897
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2011-06-15
Deactivation Date:2006-03-27
Deactivation Code:
Reactivation Date:2006-03-31
Provider Licenses
StateLicense IDTaxonomies
CADC23433111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU55676Medicare UPIN