Provider Demographics
NPI:1346393923
Name:HOYT, MICHAEL FRED (PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:FRED
Last Name:HOYT
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:90 THALIA ST
Mailing Address - Street 2:
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-2054
Mailing Address - Country:US
Mailing Address - Phone:415-444-3073
Mailing Address - Fax:415-444-3019
Practice Address - Street 1:820 LAS GALLINAS AVE
Practice Address - Street 2:
Practice Address - City:SAN RAFAEL
Practice Address - State:CA
Practice Address - Zip Code:94903-3410
Practice Address - Country:US
Practice Address - Phone:415-444-3073
Practice Address - Fax:415-444-3019
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY5598103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical