Provider Demographics
NPI:1457062382
Name:WILLIAMS, TONI MARIE
Entity type:Individual
Prefix:MRS
First Name:TONI
Middle Name:MARIE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1787 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:CA
Mailing Address - Zip Code:95971-9794
Mailing Address - Country:US
Mailing Address - Phone:760-792-8041
Mailing Address - Fax:
Practice Address - Street 1:175 N MILL CREEK RD
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:CA
Practice Address - Zip Code:95971-9678
Practice Address - Country:US
Practice Address - Phone:530-283-6550
Practice Address - Fax:530-283-6508
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator