Kathryn Joanne Williams, CSCD, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

19855 Issued in CA

Practice address

1212 College Ave
Suite a
Santa Rosa, CA 95404

Phone

(707) 542-1010

Fax

(707) 542-3232

NPI assigned

Sep 5, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Kathryn Joanne Samples Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Santa Rosa Speech & Language Services

  • Speech-Language Pathologist
  • Santa Rosa, CA
  • NPI 1891220554
  NPD Authorized official

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614297600000",
    "number": "1942559042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 FARMERS LANE",
            "address_2": "#319",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95405",
            "telephone_number": "707-542-1010",
            "fax_number": "707-542-3232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 COLLEGE AVE",
            "address_2": "SUITE A",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "95404",
            "telephone_number": "707-542-1010",
            "fax_number": "707-542-3232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "KATHRYN",
        "middle_name": "JOANNE",
        "credential": "CSCD, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-05",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "19855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHRYN",
            "last_name": "SAMPLES",
            "middle_name": "JOANNE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Connie May Williams
• Corinne Teresa Williams, A.T.
• Estrelania S Williams, M.D.
• Heather Anne Williams
• James Thomas Williams, PHYSICIAN ASST
• Kevin M Williams
• Lauren Helene Williams
• Marcia Williams, LMFT
• Marian Terese Williams
• Mark E. Williams, MD

• Speech-Language Pathologist in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Speech-Language Pathologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.