Provider Demographics
NPI:1407936305
Name:HAMILTON, CLAUDETTE ELENI (MFT)
Entity Type:Individual
Prefix:MS
First Name:CLAUDETTE
Middle Name:ELENI
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18231 HAPPY TRAILS HWY
Mailing Address - Street 2:SUITE 8
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307-2213
Mailing Address - Country:US
Mailing Address - Phone:760-946-9032
Mailing Address - Fax:760-946-9034
Practice Address - Street 1:18231 HAPPY TRAILS HWY
Practice Address - Street 2:SUITE 8
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-2213
Practice Address - Country:US
Practice Address - Phone:760-946-9032
Practice Address - Fax:760-946-9034
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC29057106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist