Individual
GARY LEWALL WILLIAMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PEER RECOVERY COACH
Contact information
Practice address
15217 SAN BERNARDINO AVE, FONTANA, CA 92335-5327
(951) 643-2150
Mailing address
15217 SAN BERNARDINO AVE, FONTANA, CA 92335-5327
(951) 643-2150
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
R1486101022
CA
175T00000X
Peer Specialist
Primary
MPSS-PCIHYD
CA
Other
Enumeration date
02/01/2022
Last updated
10/10/2025
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