Provider Demographics
NPI:1689064974
Name:WILLIAMS, TELECIA LASHAWN (RN)
Entity Type:Individual
Prefix:MS
First Name:TELECIA
Middle Name:LASHAWN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
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 824
Mailing Address - Street 2:
Mailing Address - City:BELLFLOWER
Mailing Address - State:CA
Mailing Address - Zip Code:90707-0824
Mailing Address - Country:US
Mailing Address - Phone:562-755-3149
Mailing Address - Fax:
Practice Address - Street 1:9928 FLOWER ST
Practice Address - Street 2:SUITE 200
Practice Address - City:BELLFLOWER
Practice Address - State:CA
Practice Address - Zip Code:90706-5453
Practice Address - Country:US
Practice Address - Phone:562-925-2088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-26
Last Update Date:2015-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA814745163W00000X, 163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WP0200XNursing Service ProvidersRegistered NursePediatrics