Provider Demographics
NPI:1336264605
Name:WILLIAMS, CONSTANCE (RN)
Entity Type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 SAN LEANDRO WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94127-1505
Mailing Address - Country:US
Mailing Address - Phone:650-306-1100
Mailing Address - Fax:650-306-1104
Practice Address - Street 1:643 BAIR ISLAND RD
Practice Address - Street 2:106
Practice Address - City:REDWOOD CITY
Practice Address - State:CA
Practice Address - Zip Code:94063-2754
Practice Address - Country:US
Practice Address - Phone:650-306-1100
Practice Address - Fax:650-306-1104
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA236066163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse