Provider Demographics
NPI:1003973512
Name:HAMILTON, KATHERINE LOUISE (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:LOUISE
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 PASEO CAMARILLO
Mailing Address - Street 2:SUITE 114
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-6021
Mailing Address - Country:US
Mailing Address - Phone:805-389-4770
Mailing Address - Fax:805-389-4769
Practice Address - Street 1:1000 PASEO CAMARILLO
Practice Address - Street 2:SUITE 114
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6021
Practice Address - Country:US
Practice Address - Phone:805-389-4770
Practice Address - Fax:805-389-4769
Is Sole Proprietor?:No
Enumeration Date:2007-01-03
Last Update Date:2016-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11744103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CP11744AMedicare PIN