Individual provider Active NPI

Carol Denise Williams, PH.D.

  • Clinical Psychologist
  • Los Altos, CA
National Provider Identifier
1609806553
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
PSY14211 Issued in CA
Practice address
11711 Putter Way
Los Altos, CA 94024-6322
Phone
(650) 964-3230
Fax
(650) 964-3230
NPI assigned
Jul 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X PSY14211 CA Primary

Addresses

Primary practice location

11711 Putter Way
Los Altos, CA 94024-6322

Mailing address

PO Box 391465
Mountain View, CA 94039-1465
Phone (650) 964-3230

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20051014000873 CA Practitioner - Clinical Psychologist 2466484506 Practice locations: Los Altos, CA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

11711 Putter Way
Los Altos, CA 94024-6322
Phone (650) 964-3230

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
14211CAMDMental Health Counselor
PSY14211CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1609806553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 391465",
            "city": "MOUNTAIN VIEW",
            "state": "CA",
            "postal_code": "940391465",
            "telephone_number": "650-964-3230",
            "fax_number": "650-964-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11711 PUTTER WAY",
            "city": "LOS ALTOS",
            "state": "CA",
            "postal_code": "940246322",
            "telephone_number": "650-964-3230",
            "fax_number": "650-964-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "CAROL",
        "middle_name": "DENISE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-04",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CA",
            "license": "PSY14211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Altos, CA

Sources for this page

Verify at the official NPI Registry.