Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor | H0609181446 | CA |
NPI | 1003080995 |
---|---|
Provider Name | Mr. Douglas Martin Hames |
First Address | San Jose, CA 95127-3610 |
Second Address | San Jose, CA 95127-3610 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2008 |
Last Update Date | 22/04/2008 |