Provider Demographics
NPI:1720485758
Name:WILLIAMS, TANIA (DC)
Entity Type:Individual
Prefix:DR
First Name:TANIA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2216 S EL CAMINO REAL
Mailing Address - Street 2:SUITE 208
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92054-6369
Mailing Address - Country:US
Mailing Address - Phone:516-551-2837
Mailing Address - Fax:
Practice Address - Street 1:2750 CIRCULO SANTIAGO APT L
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-6841
Practice Address - Country:US
Practice Address - Phone:516-551-2837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-19
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33123111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor