Provider Demographics
NPI:1255649778
Name:HIZAR HANSFORD, JANET ELAINE (PHD, MFT)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:ELAINE
Last Name:HIZAR HANSFORD
Suffix:
Gender:F
Credentials:PHD, MFT
Other - Prefix:DR
Other - First Name:JAN
Other - Middle Name:
Other - Last Name:JORGENSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD, MFT
Mailing Address - Street 1:PO BOX 357
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:AZ
Mailing Address - Zip Code:86332-0357
Mailing Address - Country:US
Mailing Address - Phone:661-378-0216
Mailing Address - Fax:
Practice Address - Street 1:8574 N 107TH LN
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85345-3472
Practice Address - Country:US
Practice Address - Phone:661-378-0216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-17
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMF16903106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist