Provider Demographics
NPI:1881564466
Name:WILLIAMS, SHEA (AMFT, APCC)
Entity type:Individual
Prefix:
First Name:SHEA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:X
Credentials:AMFT, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5212 KATELLA AVE STE 103B
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-6828
Mailing Address - Country:US
Mailing Address - Phone:714-253-4673
Mailing Address - Fax:
Practice Address - Street 1:5212 KATELLA AVE STE 103B
Practice Address - Street 2:
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-6828
Practice Address - Country:US
Practice Address - Phone:714-253-4673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-07
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19233101YM0800X
CA154516106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health