Provider Demographics
NPI:1316702467
Name:SEWERBRIDGES-WILLIAMS, LINDA BANN
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:BANN
Last Name:SEWERBRIDGES-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:PO BOX 721086
Mailing Address - Street 2:
Mailing Address - City:PINON HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92372-1086
Mailing Address - Country:US
Mailing Address - Phone:760-662-8548
Mailing Address - Fax:
Practice Address - Street 1:393 E WALNUT ST
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91188-0001
Practice Address - Country:US
Practice Address - Phone:626-405-7988
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW75855104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker