Provider Demographics
NPI:1790491165
Name:WILLIAMS, CHRISTINA SHARAY (LVN)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:SHARAY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:CHRISTINA
Other - Middle Name:SHARAY
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:5850 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90003-1215
Mailing Address - Country:US
Mailing Address - Phone:323-897-6000
Mailing Address - Fax:
Practice Address - Street 1:5850 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90003-1215
Practice Address - Country:US
Practice Address - Phone:323-897-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-27
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA290211164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse