Provider Demographics
NPI:1295022317
Name:HAWKINS, REBECCA JANE (ACSW)
Entity Type:Individual
Prefix:MISS
First Name:REBECCA
Middle Name:JANE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94401-3205
Mailing Address - Country:US
Mailing Address - Phone:650-579-7162
Mailing Address - Fax:
Practice Address - Street 1:416 2ND AVE
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94401-3205
Practice Address - Country:US
Practice Address - Phone:650-579-7162
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAH0510201120101YA0400X
CAASW850751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)