Provider Demographics
NPI:1316280696
Name:WILLIAMS, JOHN CHRISTOPHER (PHD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:CHRISTOPHER
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:667 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HERMOSA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90254-4726
Mailing Address - Country:US
Mailing Address - Phone:310-938-7773
Mailing Address - Fax:
Practice Address - Street 1:3363 LINDEN AVE
Practice Address - Street 2:SUITE C
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-4579
Practice Address - Country:US
Practice Address - Phone:562-988-3162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-04
Last Update Date:2013-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24656103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical