Provider Demographics
NPI:1922690874
Name:WILLIAMS, ANGELA LYNETTE
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:LYNETTE
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 1:15724 ORANGE AVE APT 223
Mailing Address - Street 2:
Mailing Address - City:PARAMOUNT
Mailing Address - State:CA
Mailing Address - Zip Code:90723-8507
Mailing Address - Country:US
Mailing Address - Phone:310-866-6707
Mailing Address - Fax:
Practice Address - Street 1:15724 ORANGE AVE APT 223
Practice Address - Street 2:
Practice Address - City:PARAMOUNT
Practice Address - State:CA
Practice Address - Zip Code:90723-8507
Practice Address - Country:US
Practice Address - Phone:310-866-6707
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-10
Last Update Date:2021-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health