Provider Demographics
NPI:1891213229
Name:WILLIAMS, ABBYE (CADC II)
Entity Type:Individual
Prefix:
First Name:ABBYE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CADC II
Other - Prefix:
Other - First Name:ABIGAIL
Other - Middle Name:
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CADC II
Mailing Address - Street 1:11100 VALLEY BLVD STE 116
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-2533
Mailing Address - Country:US
Mailing Address - Phone:626-444-0705
Mailing Address - Fax:626-444-0710
Practice Address - Street 1:11100 VALLEY BLVD SUITE 116
Practice Address - Street 2:
Practice Address - City:EL MONTE
Practice Address - State:CA
Practice Address - Zip Code:91731
Practice Address - Country:US
Practice Address - Phone:626-444-0705
Practice Address - Fax:626-444-0710
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA044600107101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)