Provider Demographics
NPI:1609043405
Name:WILLIAMS, EDDIE PAUL (MED)
Entity type:Individual
Prefix:
First Name:EDDIE
Middle Name:PAUL
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 95331
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CO
Mailing Address - Zip Code:95159
Mailing Address - Country:US
Mailing Address - Phone:753-253-7444
Mailing Address - Fax:
Practice Address - Street 1:2001 THE ALAMEDA
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1136
Practice Address - Country:US
Practice Address - Phone:408-261-7777
Practice Address - Fax:408-254-9960
Is Sole Proprietor?:No
Enumeration Date:2008-05-12
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health