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Individual

CHARLAINE IDA WILLIAMSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
9170 HAVEN AVE STE 120, RANCHO CUCAMONGA, CA 91730-5416
(909) 476-8700
(909) 987-1400
Mailing address
11422 ANZIO CT, RANCHO CUCAMONGA, CA 91701-8500
(909) 996-9903

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
19923
CA

Other

Enumeration date
03/16/2011
Last updated
04/13/2021
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