Provider Demographics
NPI:1629400825
Name:WILLIAMS, ASHLEY LYNNEA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:LYNNEA
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5719 BERTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91316-1027
Mailing Address - Country:US
Mailing Address - Phone:847-340-8890
Mailing Address - Fax:
Practice Address - Street 1:3724 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90016-5804
Practice Address - Country:US
Practice Address - Phone:323-292-7261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA67316183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist