Provider Demographics
NPI:1750433066
Name:WILLIAMS, LUCILLE KAY (PSYD)
Entity type:Individual
Prefix:DR
First Name:LUCILLE
Middle Name:KAY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 E SHAW AVE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7912
Mailing Address - Country:US
Mailing Address - Phone:559-222-8222
Mailing Address - Fax:559-222-8014
Practice Address - Street 1:1318 E SHAW AVE
Practice Address - Street 2:SUITE 320
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7912
Practice Address - Country:US
Practice Address - Phone:559-222-8222
Practice Address - Fax:559-222-8014
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY18035103TC0700X, 103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist