Provider Demographics
NPI:1255682985
Name:WILLIAMS, JEANETTE YVONNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:JEANETTE
Middle Name:YVONNE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
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Mailing Address - Street 1:14445 OLIVE VIEW DRIVE
Mailing Address - Street 2:OLIVE VIEW - UCLA MEDICAL CENTER
Mailing Address - City:SYLMAR
Mailing Address - State:CA
Mailing Address - Zip Code:91342
Mailing Address - Country:US
Mailing Address - Phone:818-364-4448
Mailing Address - Fax:818-364-3554
Practice Address - Street 1:14445 OLIVE VIEW DRIVE
Practice Address - Street 2:OLIVE VIEW - UCLA MEDICAL CENTER
Practice Address - City:SYLMAR
Practice Address - State:CA
Practice Address - Zip Code:91342
Practice Address - Country:US
Practice Address - Phone:818-364-4448
Practice Address - Fax:818-364-3554
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-20
Last Update Date:2012-09-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA11784104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker