Provider Demographics
NPI:1922291673
Name:WILLIAMS, RAYE EVELYN
Entity Type:Individual
Prefix:
First Name:RAYE
Middle Name:EVELYN
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 1:1303 W WALNUT PKWY
Mailing Address - Street 2:
Mailing Address - City:COMPTON
Mailing Address - State:CA
Mailing Address - Zip Code:90220-5030
Mailing Address - Country:US
Mailing Address - Phone:310-868-5379
Mailing Address - Fax:310-868-5398
Practice Address - Street 1:1303 WALNUT PARKWAY
Practice Address - Street 2:
Practice Address - City:COMPTON
Practice Address - State:CA
Practice Address - Zip Code:90220-5804
Practice Address - Country:US
Practice Address - Phone:310-868-5379
Practice Address - Fax:310-868-5398
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2013-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator