MS. JERIE LYNN WILLIAMS (NPI# 1124687934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124687934 |
| Entity Type | Individual |
| Full Name | MS. JERIE LYNN WILLIAMS |
| Practice Address |
1901 Church Ln San Pablo CA 94806-3707 |
| Practice Telephone | 5102363134 |
| Practice Fax Number | 5102363151 |
| Mailing Telephone | 5102363134 |
| Mailing Fax Number | 5102363151 |
| Enumeration Date | 2019-06-06 |
| Last Update Date | 2019-06-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0800X |
Clinic/Center Specialization: Recovery Care |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | TAX ID # | 68-0127450 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881114676 | Jerie Lynn Williams | Nurse Practitioner | 6991 N State St, Redwood Valley, CA 95470-9629 | 2017-06-22 |
| Street Address |
1901 CHURCH LN |
| City | SAN PABLO |
| State | CA |
| Zip Code | 94806-3707 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245352962 | Ujima Family Recovery Services | Substance Abuse Rehabilitation Facility | 1901 Church Ln, San Pablo, CA 94806-3707 | 2007-04-04 |
| 1194337576 | Maureen Lucille Brannon | Counselor | 1901 Church Ln, San Pablo, CA 94806-3707 | 2020-08-18 |
| 1982236717 | Rita Schank | Counselor | 1901 Church Ln, San Pablo, CA 94806-3707 | 2020-02-10 |
| 1104457878 | Tamicha Charmaine Bell | Counselor | 1901 Church Ln, San Pablo, CA 94806-3707 | 2020-01-30 |
| 1285280834 | Jamy Renee Kappel | Counselor | 1901 Church Ln, San Pablo, CA 94806-3707 | 2019-08-09 |
| 1982162756 | Christina Nicholson | Counselor | 1901 Church Ln, San Pablo, CA 94806-3707 | 2019-03-11 |
| 1467943464 | Gail Rigelhaupt | Marriage & Family Therapist | 1901 Church Ln, San Pablo, CA 94806-3707 | 2018-05-24 |
| 1386150084 | Rachel Vasquez | Counselor | 1901 Church Ln, San Pablo, CA 94806-3707 | 2017-12-18 |
| 1508375643 | Chelsea Hall | Marriage & Family Therapist | 1901 Church Ln, San Pablo, CA 94806-3707 | 2017-09-20 |
| 1477072601 | Kimberly Mascaro | Marriage & Family Therapist | 1901 Church Ln, San Pablo, CA 94806-3707 | 2017-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013574375 | Alejandra Valle | Behavior Technician | 2970 Hilltop Mall Rd Suite 104, Richmond, CA 94806 | 2019-05-22 |
| 1629535042 | Kaitlin Sue Oshiro | Specialist/Technologist | 16401 San Pablo Ave. Spc 153, San Pablo, CA 94806 | 2019-02-21 |
| 1114400561 | Alan Gonzalez | Pharmacist | 13691 San Pablo Ave., San Pablo, CA 94806 | 2018-09-12 |
| 1265918783 | Laurel Dunn | Student in an Organized Health Care Education/Training Program | 15501 San Pablo Ave # G317, Richmond, CA 94806 | 2018-07-17 |
| 1720503592 | Monika Tippie | Marriage & Family Therapist | West County Adult Mental Health, 13585 San Pablo Ave, 2nd Floor, San Pablo, CA 94806 | 2017-08-14 |
| 1225553902 | Charles Marco Aquilina | Student in an Organized Health Care Education/Training Program | Y Team, 3260 Blume Dr., Suite 450, Richmond, CA 94806 | 2017-08-03 |
| 1922538545 | Hui-teh Hsu | Pharmacist | 2714 Holly St, San Pablo, CA 94806 | 2017-06-15 |
| 1063942878 | Meng-ju Yang | Student in an Organized Health Care Education/Training Program | 3260 Blume Dr., Suite 450, Richmond, CA 94806 | 2017-06-14 |
| 1346780020 | Mae Mayfield | Social Worker | 3600 Sierra Ridge Drive Apt # 7304, Richmond, CA 94806 | 2017-03-01 |
| 1487000790 | Pasha Jackson | Family Medicine | 2970 Hilltop Mall Rd Ste 304, Richmond, CA 94806 | 2016-05-05 |
| Find all providers in zip 94806 | ||||
| Taxonomy Code | 261QR0800X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Recovery Care |
| Definition to come... |
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| 1104293141 | Jwch Institute, Inc. | Clinic/Center | 303 E 52nd St, Los Angeles, CA 90011-4513 | 2015-08-25 |
| 1750633871 | Cheznie Recovery Group | Clinic/Center | 14061 Chestnut St, Westminster, CA 92683-4262 | 2012-10-12 |
| 1992005359 | Tresses Etc | Clinic/Center | 5740 Kiyot Way, Playa Vista, CA 90094-2102 | 2010-11-01 |
| 1780860502 | Jwch Institute Inc. | Clinic/Center | 1218 E Compton Blvd, Compton, CA 90221-3310 | 2008-01-10 |
| 1548465958 | Basen Inc | Clinic/Center | 460 E Carson Plaza Dr Ste 106, Carson, CA 90746-3270 | 2007-06-15 |
| 1952518649 | Genesis Substance Abuse Services | Clinic/Center | 7475 N Palm Ave Ste 107, Fresno, CA 93711-5763 | 2007-05-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.