Provider Demographics
NPI:1750677555
Name:WILLIAMS, KRISTEN KAY (MSW)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:KAY
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2611 GRANT AVE
Mailing Address - Street 2:FRNT
Mailing Address - City:REDONDO BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90278-3826
Mailing Address - Country:US
Mailing Address - Phone:424-241-8334
Mailing Address - Fax:
Practice Address - Street 1:2611 GRANT AVE
Practice Address - Street 2:FRNT
Practice Address - City:REDONDO BEACH
Practice Address - State:CA
Practice Address - Zip Code:90278-3826
Practice Address - Country:US
Practice Address - Phone:424-241-8334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker