Individual provider Active NPI

Lakisha Williams

  • Social Worker
  • West Sacramento, CA
National Provider Identifier
1003332636
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
106372 Issued in CA
Practice address
3120 Freeboard Dr # 102
West Sacramento, CA 95691-5039
Phone
(530) 351-7975
NPI assigned
Aug 15, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 106372 CA Primary
Social Worker 104100000X
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

3120 Freeboard Dr # 102
West Sacramento, CA 95691-5039

Mailing address

270 Sutley Cir
Sacramento, CA 95835-2042
Phone (707) 720-6006

Other practice location 1

3800 Coolidge Ave
Oakland, CA 94602-3311
Phone (510) 482-2244 ext. 334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
106372CAMDSocial Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1003332636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 SUTLEY CIR",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958352042",
            "telephone_number": "707-720-6006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 FREEBOARD DR # 102",
            "city": "WEST SACRAMENTO",
            "state": "CA",
            "postal_code": "956915039",
            "telephone_number": "530-351-7975"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 Coolidge Ave",
            "address_purpose": "LOCATION",
            "city": "Oakland",
            "state": "CA",
            "postal_code": "946023311",
            "country_code": "US",
            "telephone_number": "510-482-2244 x334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "LAKISHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-15",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "106372",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.