Active NPI
Collette Renae Williams, BS
- Case Manager/Care Coordinator
- Los Angeles, CA
National Provider Identifier
1285913616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 470 E 3Rd St Ste C
Los Angeles, CA 90013 - Phone
- (213) 620-5712
- NPI assigned
- Aug 16, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
470 E 3Rd St Ste C
Los Angeles, CA 90013
Mailing address
928 Broadway
San Diego, CA 92101-5514
Phone (619) 977-3716
Other practice location 1
1675 Morena Blvd
San Diego, CA 92110-3703
Phone (619) 275-8000
Other practice location 2
928 Broadway
San Diego, CA 92101
Phone (619) 977-3716
Other practice location 3
928 Broadway
San Diego, CA 92101
Phone (619) 977-3716
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
- Credentials
- Bachelor of Science
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Research Foundation Inc | Past | Accepting new patients | |
| Community Research Foundation Inc | Case Manager/Care Coordinator | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1255693420
-
- Community/Behavioral Health Agency
- San Diego, CA
- NPI 1952328700
Case Manager/Care Coordinator
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1313452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566432000000",
"number": "1285913616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "928 BROADWAY",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921015514",
"telephone_number": "619-977-3716"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "470 E 3RD ST STE C",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90013",
"telephone_number": "213-620-5712"
}
],
"practiceLocations": [
{
"address_1": "1675 Morena Blvd",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921103703",
"country_code": "US",
"telephone_number": "619-275-8000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "928 Broadway",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "92101",
"country_code": "US",
"telephone_number": "619-977-3716",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "928 Broadway",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "92101",
"country_code": "US",
"telephone_number": "619-977-3716",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILLIAMS",
"first_name": "COLLETTE",
"middle_name": "RENAE",
"credential": "BS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-16",
"last_updated": "2019-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.