Provider Demographics
NPI:1275970097
Name:BRANCH, HANNAH K (LMFT)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:K
Last Name:BRANCH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 BAY BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91911-2670
Mailing Address - Country:US
Mailing Address - Phone:619-585-7686
Mailing Address - Fax:619-585-7699
Practice Address - Street 1:1161 BAY BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91911-2670
Practice Address - Country:US
Practice Address - Phone:619-585-7686
Practice Address - Fax:619-585-7699
Is Sole Proprietor?:No
Enumeration Date:2013-06-03
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 390200000X
CAIMF 82108106H00000X
CA97498106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program