Provider Demographics
NPI:1447871561
Name:WILLIAMS, RONIKA
Entity type:Individual
Prefix:
First Name:RONIKA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 98TH AVE APT 55598TH
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94603-2100
Mailing Address - Country:US
Mailing Address - Phone:510-514-1207
Mailing Address - Fax:
Practice Address - Street 1:555 98TH AVE APT 55598TH
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94603-2100
Practice Address - Country:US
Practice Address - Phone:510-514-5279
Practice Address - Fax:510-514-1207
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health