Provider Demographics
NPI:1114038197
Name:HAMMES, MARY (MFT)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:
Last Name:HAMMES
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 390215
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94039-0215
Mailing Address - Country:US
Mailing Address - Phone:650-493-4932
Mailing Address - Fax:
Practice Address - Street 1:4153 EL CAMINO WAY STE A
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-4034
Practice Address - Country:US
Practice Address - Phone:650-493-4932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT38107106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist