Active NPI
Karen P Williams, PH.D.
- Clinical Psychologist
- Rancho Cucamonga, CA
National Provider Identifier
1619004173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PSY12198
- Practice address
- 10737 Laurel St Ste 230
Rancho Cucamonga, CA 91730-7659 - Phone
- (909) 989-5556
- Fax
- (909) 989-5558
- NPI assigned
- Feb 28, 2007
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY12198 | CA | Primary |
| Clinical Child & Adolescent Psychologist | 103TC2200X | PSY12198 | CA |
Addresses
Primary practice location
10737 Laurel St Ste 230
Rancho Cucamonga, CA 91730-7659
Mailing address
10737 Laurel St Ste 230
Rancho Cucamonga, CA 91730-7659
Phone (909) 989-5556
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090511000407 | CA | Practitioner - Clinical Psychologist | 3375691827 | Practice locations: Rancho Cucamonga, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY12198 | CA | MD | Clinical Child & Adolescent Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1682467200000",
"number": "1619004173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10737 LAUREL ST STE 230",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917307659",
"telephone_number": "909-989-5556",
"fax_number": "909-989-5558"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10737 LAUREL ST STE 230",
"city": "RANCHO CUCAMONGA",
"state": "CA",
"postal_code": "917307659",
"telephone_number": "909-989-5556",
"fax_number": "909-989-5558"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KAREN",
"middle_name": "P",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2023-04-26",
"certification_date": "2023-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY12198",
"primary": true
},
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "CA",
"license": "PSY12198",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rancho Cucamonga, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2023; 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.