Provider Demographics
NPI:1225371438
Name:NG, HAWLAN (PSYD)
Entity Type:Individual
Prefix:
First Name:HAWLAN
Middle Name:
Last Name:NG
Suffix:
Gender:M
Credentials:PSYD
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 3076
Mailing Address - Street 2:
Mailing Address - City:ALAMEDA
Mailing Address - State:CA
Mailing Address - Zip Code:94501-8376
Mailing Address - Country:US
Mailing Address - Phone:510-409-3928
Mailing Address - Fax:
Practice Address - Street 1:1415 WEBSTER ST UNIT 3076
Practice Address - Street 2:
Practice Address - City:ALAMEDA
Practice Address - State:CA
Practice Address - Zip Code:94501-7845
Practice Address - Country:US
Practice Address - Phone:510-409-3928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-05
Last Update Date:2013-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20462103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical