Corlette Vanessa Williams

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

111210 Issued in CA

Practice address

7200 Bancroft Ave Ste 125a
Oakland, CA 94605-2457

Phone

(510) 777-3800

Fax

(510) 777-3806

NPI assigned

Jul 21, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Grow Healthcare Group PC

  • Mental Health Counselor
  • San Jose, CA
  • NPI 1154994846

  Clinical

  Medicare reassignment NPD
• Alameda County

  • Community/Behavioral Health Agency
  • Hayward, CA
  • NPI 1780716381
  Medicare reassignment
• Alameda County

  • Community/Behavioral Health Agency
  • Castro Valley, CA
  • NPI 1083850580
  NPD
• County of Alameda

  • Community/Behavioral Health Agency
  • Alameda, CA
  • NPI 1548392145
  NPD (past)

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

{
    "created_epoch": "1469059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666656000000",
    "number": "1457704777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 BANCROFT AVE STE 125A",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052457",
            "telephone_number": "510-777-3800",
            "fax_number": "510-777-3806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7200 BANCROFT AVE STE 125A",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946052457",
            "telephone_number": "510-777-3800",
            "fax_number": "510-777-3806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CORLETTE",
        "middle_name": "VANESSA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-21",
        "last_updated": "2022-10-25",
        "certification_date": "2022-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "111210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carol Lynn Williams, RN, MSN-FNP
• Chandra Renee Williams
• Chara Williams
• Charles Verdell Williams
• Che'Rhonda Rejina Williams
• Danielle Cherie Williams, M.D.
• David Williams
• Dejada L Williams
• Delyse R. Williams, MD
• Diamond Shrice Williams

• Clinical Social Worker in Oakland, CA
• Providers in Oakland, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.