Provider Demographics
NPI:1619045218
Name:VAN HOUTEN-WILLIAMS, CATHARINA MARIA (DC)
Entity Type:Individual
Prefix:
First Name:CATHARINA
Middle Name:MARIA
Last Name:VAN HOUTEN-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:PO BOX 77790
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:CA
Mailing Address - Zip Code:92877-0126
Mailing Address - Country:US
Mailing Address - Phone:951-278-5590
Mailing Address - Fax:951-272-9924
Practice Address - Street 1:11413 MOORPARK ST
Practice Address - Street 2:
Practice Address - City:STUDIO CITY
Practice Address - State:CA
Practice Address - Zip Code:91602-2009
Practice Address - Country:US
Practice Address - Phone:818-506-6696
Practice Address - Fax:818-506-6693
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2015-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC30380111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA30380OtherMEDICAL LICENSE