Provider Demographics
NPI:1659732626
Name:WILLIAMS-BROWN, MERCEDES (MS)
Entity Type:Individual
Prefix:
First Name:MERCEDES
Middle Name:
Last Name:WILLIAMS-BROWN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 CABRILLO AVE
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-3632
Mailing Address - Country:US
Mailing Address - Phone:310-787-7315
Mailing Address - Fax:
Practice Address - Street 1:901 N PACIFIC COAST HWY STE 200A
Practice Address - Street 2:
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90277-7702
Practice Address - Country:US
Practice Address - Phone:310-906-6752
Practice Address - Fax:310-921-5327
Is Sole Proprietor?:No
Enumeration Date:2016-03-17
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAIMF74423106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAIMF74423Other106H00000X