Individual
JACI WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
255 W 5TH ST APT 1422, SAN PEDRO, CA 90731-8403
(310) 259-4660
Mailing address
255 W 5TH ST APT 1422, SAN PEDRO, CA 90731-8403
(310) 259-4660
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
690905
CA
163WI0500X
Infusion Therapy Registered Nurse
690905
CA
163WM0705X
Medical-Surgical Registered Nurse
690905
CA
Other
Enumeration date
10/15/2019
Last updated
10/15/2019
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