Provider Demographics
NPI:1336347145
Name:WILLIAMS, JUDITH ANN (MSW)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:ANN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 FIFER AVE.
Mailing Address - Street 2:STE.200
Mailing Address - City:CORTE MADERA
Mailing Address - State:CA
Mailing Address - Zip Code:94925-1744
Mailing Address - Country:US
Mailing Address - Phone:415-927-6693
Mailing Address - Fax:707-869-3563
Practice Address - Street 1:2 FIFER AVE
Practice Address - Street 2:STE.200
Practice Address - City:CORTE MADERA
Practice Address - State:CA
Practice Address - Zip Code:94925-1134
Practice Address - Country:US
Practice Address - Phone:415-927-6693
Practice Address - Fax:707-869-3563
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS132121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACSW13212.0Medicaid
CACSW13212.0Medicaid