Provider Demographics
NPI:1275070864
Name:HANKEN, MARLA (CMT, BCSI, NBC-HWC)
Entity Type:Individual
Prefix:
First Name:MARLA
Middle Name:
Last Name:HANKEN
Suffix:
Gender:F
Credentials:CMT, BCSI, NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4831 GEARY BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-2910
Mailing Address - Country:US
Mailing Address - Phone:415-745-9471
Mailing Address - Fax:
Practice Address - Street 1:4831 GEARY BLVD
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-2910
Practice Address - Country:US
Practice Address - Phone:415-745-9471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-20
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
CA9820225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No171400000XOther Service ProvidersHealth & Wellness Coach