Provider Demographics
NPI:1750040853
Name:WILLIAMS, JOVANNA
Entity Type:Individual
Prefix:
First Name:JOVANNA
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 1:4980 HILLSDALE CIR
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-5726
Mailing Address - Country:US
Mailing Address - Phone:153-021-0730
Mailing Address - Fax:
Practice Address - Street 1:4980 HILLSDALE CIR
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-5726
Practice Address - Country:US
Practice Address - Phone:530-210-7307
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician