Provider Demographics
NPI:1427562958
Name:HALE, CAROLANNE MARY (BA, MA, MS)
Entity Type:Individual
Prefix:
First Name:CAROLANNE
Middle Name:MARY
Last Name:HALE
Suffix:
Gender:F
Credentials:BA, MA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3179 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-7595
Mailing Address - Country:US
Mailing Address - Phone:925-452-4465
Mailing Address - Fax:
Practice Address - Street 1:3179 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-7595
Practice Address - Country:US
Practice Address - Phone:925-452-4465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA93546106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty