Provider Demographics
NPI:1306686290
Name:WILLIAMS, TEMICKA T (PA)
Entity type:Individual
Prefix:MS
First Name:TEMICKA
Middle Name:T
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:MS
Other - First Name:TEMICKA
Other - Middle Name:T
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1218 17TH AVE APT D1
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-4251
Mailing Address - Country:US
Mailing Address - Phone:601-672-0816
Mailing Address - Fax:
Practice Address - Street 1:2570 48TH ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1541
Practice Address - Country:US
Practice Address - Phone:916-734-2145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program