Provider Demographics
NPI:1124360342
Name:UNIVERSITY OF CALIFORNIA RIVERSIDE
Entity Type:Organization
Organization Name:UNIVERSITY OF CALIFORNIA RIVERSIDE
Other - Org Name:COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:951-827-5531
Mailing Address - Street 1:900 UNIVERSITY AVE
Mailing Address - Street 2:VEITCH STUDENT CENTER, NORTH WING
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92521
Mailing Address - Country:US
Mailing Address - Phone:951-827-5531
Mailing Address - Fax:951-827-2015
Practice Address - Street 1:900 UNIVERSITY AVE
Practice Address - Street 2:VEITCH STUDENT CENTER, NORTH WING
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92521
Practice Address - Country:US
Practice Address - Phone:951-827-5531
Practice Address - Fax:951-827-2015
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounselingGroup - Single Specialty