Provider Demographics
NPI:1184745721
Name:WILLIAMS, CAROL ANN (LPT)
Entity type:Individual
Prefix:MISS
First Name:CAROL
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LPT
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Mailing Address - Street 1:1532 DOUGLAS RD
Mailing Address - Street 2:
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95207-4113
Mailing Address - Country:US
Mailing Address - Phone:209-951-3185
Mailing Address - Fax:
Practice Address - Street 1:4422 N PERSHING AVE
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95207-6954
Practice Address - Country:US
Practice Address - Phone:209-953-8843
Practice Address - Fax:209-953-8478
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT29591167G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes167G00000XNursing Service ProvidersLicensed Psychiatric Technician