Provider Demographics
NPI:1679038780
Name:WILLIAMS, JAMES (CHT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:CHT
Other - Prefix:MR
Other - First Name:DAVID
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CHT
Mailing Address - Street 1:PO BOX 1584
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95402-1584
Mailing Address - Country:US
Mailing Address - Phone:707-483-3102
Mailing Address - Fax:
Practice Address - Street 1:876 HIGHWAY 116 S STE 6
Practice Address - Street 2:
Practice Address - City:SEBASTOPOL
Practice Address - State:CA
Practice Address - Zip Code:95472-4545
Practice Address - Country:US
Practice Address - Phone:707-483-3102
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-02
Last Update Date:2019-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health