Provider Demographics
NPI:1750574596
Name:HARRIS, WILLIAM WALTER
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:WALTER
Last Name:HARRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68615 PEREZ RD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-7200
Mailing Address - Country:US
Mailing Address - Phone:760-770-2267
Mailing Address - Fax:760-770-2240
Practice Address - Street 1:14320 PALM DR
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240-6874
Practice Address - Country:US
Practice Address - Phone:951-955-3306
Practice Address - Fax:760-770-2250
Is Sole Proprietor?:No
Enumeration Date:2007-08-24
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)