Provider Demographics
NPI:1386707990
Name:WILLIAMS, CHRISTINE LYNN (LCSW)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:LYNN
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:WILLIAMS
Other - Last Name:CHU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:17296 SLOVER AVE
Mailing Address - Street 2:
Mailing Address - City:FONTANA
Mailing Address - State:CA
Mailing Address - Zip Code:92337-7585
Mailing Address - Country:US
Mailing Address - Phone:909-974-4770
Mailing Address - Fax:909-974-4701
Practice Address - Street 1:3330 CENTRE LAKE DR
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91761-1211
Practice Address - Country:US
Practice Address - Phone:909-974-4770
Practice Address - Fax:909-974-4701
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS112031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical