Provider Demographics
NPI:1144428467
Name:JOANNE M. HAMILTON PSYCHOLOGIST A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:JOANNE M. HAMILTON PSYCHOLOGIST A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:858-693-3113
Mailing Address - Street 1:9968 HIBERT ST STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-1036
Mailing Address - Country:US
Mailing Address - Phone:858-693-3113
Mailing Address - Fax:858-312-8460
Practice Address - Street 1:9968 HIBERT ST STE 105
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-1036
Practice Address - Country:US
Practice Address - Phone:858-693-3113
Practice Address - Fax:858-312-8460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-08
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18998103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1649211178OtherPRACTITIONER NPI