Provider Demographics
NPI:1285399105
Name:WILLIAMS, HANNAH PRENTISS
Entity type:Individual
Prefix:MRS
First Name:HANNAH
Middle Name:PRENTISS
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 1:9602 ERSKINE DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92646-6009
Mailing Address - Country:US
Mailing Address - Phone:513-767-7807
Mailing Address - Fax:
Practice Address - Street 1:2900 BRISTOL ST STE H103
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-7916
Practice Address - Country:US
Practice Address - Phone:714-248-6892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-04
Last Update Date:2021-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA120028106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist