Provider Demographics
NPI:1376708230
Name:WILLIAMS, KAREN RENEE (AMFT 130036)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:RENEE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:AMFT 130036
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2260 E PALMDALE BLVD STE J
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93550-4952
Mailing Address - Country:US
Mailing Address - Phone:661-757-1800
Mailing Address - Fax:
Practice Address - Street 1:2260 E PALMDALE BLVD STE J
Practice Address - Street 2:
Practice Address - City:PALMDALE
Practice Address - State:CA
Practice Address - Zip Code:93550-4952
Practice Address - Country:US
Practice Address - Phone:661-757-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-21
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA130036106H00000X
CA102495101YA0400X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA373781Medicaid