Provider Demographics
NPI:1629269204
Name:WILLIAMS, CRISTINA
Entity type:Individual
Prefix:MS
First Name:CRISTINA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 LANDSFORD ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93535-2724
Mailing Address - Country:US
Mailing Address - Phone:323-394-2584
Mailing Address - Fax:
Practice Address - Street 1:805 LANDSFORD ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93535-2724
Practice Address - Country:US
Practice Address - Phone:323-394-2584
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-07
Last Update Date:2025-10-17
Deactivation Date:2025-07-15
Deactivation Code:
Reactivation Date:2025-10-06
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CA172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA7420Medicaid
CA7068Medicaid