Provider Demographics
NPI:1457568636
Name:WILLIAMS, ANITA RUTH (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:RUTH
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11453 SILVERADO WAY
Mailing Address - Street 2:
Mailing Address - City:YUCAIPA
Mailing Address - State:CA
Mailing Address - Zip Code:92399-6859
Mailing Address - Country:US
Mailing Address - Phone:909-226-4949
Mailing Address - Fax:909-885-2166
Practice Address - Street 1:1325 S AUTO PLAZA DR
Practice Address - Street 2:SUITE 110
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92408-2762
Practice Address - Country:US
Practice Address - Phone:909-226-4949
Practice Address - Fax:909-885-2166
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC35892106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist