Provider Demographics
NPI:1215461918
Name:WILLIAMS, LARUEBETTY JEAN (ASW)
Entity type:Individual
Prefix:
First Name:LARUEBETTY
Middle Name:JEAN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2226 MACARTHUR BLVD UNIT 27322
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94602-5021
Mailing Address - Country:US
Mailing Address - Phone:510-381-0033
Mailing Address - Fax:
Practice Address - Street 1:2226 MACARTHUR BLVD UNIT 27322
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94602-5021
Practice Address - Country:US
Practice Address - Phone:510-381-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-19
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW99250104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker