Provider Demographics
NPI:1588134928
Name:WILLIAMS, CHRISTINE (MA, CADA II, ICADC)
Entity type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:MA, CADA II, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6145 IMPERIAL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92114-4213
Mailing Address - Country:US
Mailing Address - Phone:817-714-6622
Mailing Address - Fax:619-234-7787
Practice Address - Street 1:6145 IMPERIAL AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92114-4213
Practice Address - Country:US
Practice Address - Phone:817-714-6622
Practice Address - Fax:619-234-7787
Is Sole Proprietor?:No
Enumeration Date:2018-11-28
Last Update Date:2018-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARA8901117101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)