Provider Demographics
NPI:1134005465
Name:WILLIAMS, ELLI (CPT, RYT)
Entity type:Individual
Prefix:
First Name:ELLI
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:CPT, RYT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 HYDE PARK PL
Mailing Address - Street 2:
Mailing Address - City:INGLEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90302-1601
Mailing Address - Country:US
Mailing Address - Phone:424-376-9937
Mailing Address - Fax:
Practice Address - Street 1:517 HYDE PARK PL
Practice Address - Street 2:
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90302-1601
Practice Address - Country:US
Practice Address - Phone:424-376-9937
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer