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Individual

MRS. MARA SUSAN WILLIAMS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
3417 VALLE VERDE DR, NAPA, CA 94558-2414
(707) 255-4172
(707) 255-2605
Mailing address
19337 ORANGE AVE, SONOMA, CA 95476-6215
(707) 996-6219

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
345522
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15902
NP FURNISHING NUMBER
CA
01
345522
RN LICENSE
CA
Enumeration date
01/17/2007
Last updated
03/07/2023
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