Provider Demographics
NPI:1063698884
Name:WILLIAMS, LANA P (MD)
Entity type:Individual
Prefix:
First Name:LANA
Middle Name:P
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 E. SHAW AVE.
Mailing Address - Street 2:410
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-7904
Mailing Address - Country:US
Mailing Address - Phone:559-226-1316
Mailing Address - Fax:559-226-1315
Practice Address - Street 1:1322 E. SHAW AVE.
Practice Address - Street 2:410
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93710-7904
Practice Address - Country:US
Practice Address - Phone:559-226-1316
Practice Address - Fax:559-226-1315
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA999332084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry