Provider Demographics
NPI:1598897415
Name:WILLIAMS, KAY MARIE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:KAY
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4120 CAMERON PARK DR
Mailing Address - Street 2:SUITE 302-A
Mailing Address - City:CAMERON PARK
Mailing Address - State:CA
Mailing Address - Zip Code:95682-7212
Mailing Address - Country:US
Mailing Address - Phone:530-647-2912
Mailing Address - Fax:530-672-8071
Practice Address - Street 1:4120 CAMERON PARK DR
Practice Address - Street 2:SUITE 302-A
Practice Address - City:CAMERON PARK
Practice Address - State:CA
Practice Address - Zip Code:95682-7212
Practice Address - Country:US
Practice Address - Phone:530-647-2912
Practice Address - Fax:530-672-8071
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC28818106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist