Provider Demographics
NPI:1851066526
Name:WILLIAMS, ERIN (EDS,PPS, NCSP)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:EDS,PPS, NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 BRUBAKER DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5407
Mailing Address - Country:US
Mailing Address - Phone:925-683-3388
Mailing Address - Fax:
Practice Address - Street 1:41 BRUBAKER DR
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5407
Practice Address - Country:US
Practice Address - Phone:925-683-3388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-13
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA200227444103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool