Individual
MICHELLE WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4309 3RD AVE, SAN DIEGO, CA 92103-1407
(619) 876-4502
Mailing address
3833 MIDWAY DR APT 117, SAN DIEGO, CA 92110-5210
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
823428
CA
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
823428
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1013363118
—
CA
Enumeration date
05/06/2016
Last updated
05/05/2018
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