Individual
MISS GARTH RICHARD WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
303 POTRERO ST, SANTA CRUZ, CA 95060-2741
(831) 466-9307
(831) 466-9748
Mailing address
PO BOX 5182, SANTA CRUZ, CA 95063-5182
(831) 332-1550
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
768633
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
44AV
MEDI-CAL
CA
Enumeration date
09/21/2010
Last updated
09/21/2010
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