Provider Demographics
NPI:1699896365
Name:WILLIAMSON, RENE LEE (LMFT)
Entity type:Individual
Prefix:
First Name:RENE
Middle Name:LEE
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12520 HIGH BLUFF DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2041
Mailing Address - Country:US
Mailing Address - Phone:858-259-0599
Mailing Address - Fax:
Practice Address - Street 1:12520 HIGH BLUFF DR
Practice Address - Street 2:SUITE 120
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2041
Practice Address - Country:US
Practice Address - Phone:858-259-0599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPPS CREDENTIAL101YS0200X
CAMFC37531106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist