Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | 114576 | CA |
NPI | 1235786930 |
---|---|
Provider Name | Megan Elizabeth Hamilton |
First Address | Oakland, CA 94602-2815 |
Second Address | Hayward, CA 94545-2341 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/08/2019 |
Last Update Date | 19/08/2019 |