Provider Demographics
NPI:1740575604
Name:WILLIAMS, PATRICIA SKINNER (RN, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:SKINNER
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:252 VIA GAYUBA
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-4323
Mailing Address - Country:US
Mailing Address - Phone:831-644-9659
Mailing Address - Fax:831-646-8738
Practice Address - Street 1:529 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PACIFIC GROVE
Practice Address - State:CA
Practice Address - Zip Code:93950-2732
Practice Address - Country:US
Practice Address - Phone:831-917-6387
Practice Address - Fax:831-657-9702
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA471203163W00000X
CA174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No174N00000XOther Service ProvidersLactation Consultant, Non-RN