Provider Demographics
NPI:1508021775
Name:WILLIAMS, SONGAYA SHYNIQUE (LVN)
Entity Type:Individual
Prefix:MS
First Name:SONGAYA
Middle Name:SHYNIQUE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:MS
Other - First Name:SONNIE
Other - Middle Name:S
Other - Last Name:WILLIIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LVN
Mailing Address - Street 1:2097 REEDY AVE # 3
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92346-4537
Mailing Address - Country:US
Mailing Address - Phone:909-425-9016
Mailing Address - Fax:
Practice Address - Street 1:2097 REEDY AVE # 3
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:CA
Practice Address - Zip Code:92346-4537
Practice Address - Country:US
Practice Address - Phone:909-425-9016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-27
Last Update Date:2008-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA187443164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse