Provider Demographics
NPI:1619031564
Name:WILLIAMS, ERIN ELAINE (MFT)
Entity Type:Individual
Prefix:MS
First Name:ERIN
Middle Name:ELAINE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:MS
Other - First Name:ERIN
Other - Middle Name:ELAINE
Other - Last Name:WOLCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MFT
Mailing Address - Street 1:3853 ROSECRANS ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92110-3115
Mailing Address - Country:US
Mailing Address - Phone:619-692-8232
Mailing Address - Fax:619-542-4060
Practice Address - Street 1:3853 ROSECRANS ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-3115
Practice Address - Country:US
Practice Address - Phone:619-692-8232
Practice Address - Fax:619-542-4060
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49053106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist