Provider Demographics
NPI:1316767445
Name:WILLIAMS, CANDY R (BCBA)
Entity type:Individual
Prefix:
First Name:CANDY
Middle Name:R
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5565 E ANAHEIM RD # 8032
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-4329
Mailing Address - Country:US
Mailing Address - Phone:562-453-9760
Mailing Address - Fax:
Practice Address - Street 1:5565 E ANAHEIM RD # 8032
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-4329
Practice Address - Country:US
Practice Address - Phone:562-453-9760
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-14
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst