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Individual

ANGELA R WILLIAMS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DIET TECHNICIAN

Contact information

Practice address
298 W FUEGO ST, LONG BEACH, CA 90805-1117
(310) 537-1025
Mailing address
298 W FUEGO ST, LONG BEACH, CA 90805-1117
(310) 537-1025

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
BU20815760
CA
133NN1002X
Nutrition Education Nutritionist
Primary
BU20815760
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
133NN1002X
NUTRITION & FITNESS CONSULTANT
CA
Enumeration date
09/02/2009
Last updated
09/02/2009
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