Provider Demographics
NPI:1982778205
Name:WILLIAMSON, JAMES DALE (LMFT)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DALE
Last Name:WILLIAMSON
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1081 WINTON WAY
Mailing Address - Street 2:
Mailing Address - City:ATWATER
Mailing Address - State:CA
Mailing Address - Zip Code:95301-3502
Mailing Address - Country:US
Mailing Address - Phone:209-357-0600
Mailing Address - Fax:209-357-1008
Practice Address - Street 1:1081 WINTON WAY
Practice Address - Street 2:
Practice Address - City:ATWATER
Practice Address - State:CA
Practice Address - Zip Code:95301-3502
Practice Address - Country:US
Practice Address - Phone:209-357-0600
Practice Address - Fax:209-357-1008
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17174106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist