Basic Information
| Provider Information | |||||||||
| NPI: | 1750689766 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | WILLIAMS | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | ANN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3331 SHERI DR APT A | ||||||||
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| City: | SIMI VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930637119 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8052172235 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2975 SYCAMORE DR | ||||||||
| Address2: | |||||||||
| City: | SIMI VALLEY | ||||||||
| State: | CA | ||||||||
| PostalCode: | 930651201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8054984344 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2011 | ||||||||
| LastUpdateDate: | 03/01/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2278G1100X | 00029844 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | General Care |
No ID Information.