Provider Demographics
NPI:1235897018
Name:HATTON, COLE CALLUM
Entity Type:Individual
Prefix:
First Name:COLE
Middle Name:CALLUM
Last Name:HATTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CECELIA
Other - Middle Name:M
Other - Last Name:HATTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 399318
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94139-9318
Mailing Address - Country:US
Mailing Address - Phone:866-523-4268
Mailing Address - Fax:
Practice Address - Street 1:155 GRAND AVE STE 500
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94612-3747
Practice Address - Country:US
Practice Address - Phone:510-987-8256
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician