Active NPI
Katherine Jean Williams, PAC
- Physician Assistant
- Thousand Oaks, CA
National Provider Identifier
1861689390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 53416
- Practice address
- 375 Rolling Oaks Dr
Suite 210
Thousand Oaks, CA 91361-1023 - Phone
- (805) 497-7015
- Fax
- (805) 497-7315
- NPI assigned
- Sep 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 2007028606 | MO | |
| Physician Assistant | 363A00000X | 53416 | CA | Primary |
Addresses
Primary practice location
375 Rolling Oaks Dr
Suite 210
Thousand Oaks, CA 91361-1023
Mailing address
375 Rolling Oaks Dr
Suite 210
Thousand Oaks, CA 91361-1023
Phone (805) 497-7015
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 53416 | CA | MD | Physician Assistant |
| 2007028606 | MO | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190937600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1486425600000",
"number": "1861689390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "375 ROLLING OAKS DR",
"address_2": "SUITE 210",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913611023",
"telephone_number": "805-497-7015",
"fax_number": "805-497-7315"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "375 ROLLING OAKS DR",
"address_2": "SUITE 210",
"city": "THOUSAND OAKS",
"state": "CA",
"postal_code": "913611023",
"telephone_number": "805-497-7015",
"fax_number": "805-497-7315"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILLIAMS",
"first_name": "KATHERINE",
"middle_name": "JEAN",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-28",
"last_updated": "2017-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MO",
"license": "2007028606",
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "CA",
"license": "53416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Thousand Oaks, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.