Provider Demographics
NPI:1467441360
Name:HINCKLE, ANNE HART (MFT)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:HART
Last Name:HINCKLE
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 1:1616 SANCHEZ AVE
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-4919
Mailing Address - Country:US
Mailing Address - Phone:650-342-6847
Mailing Address - Fax:
Practice Address - Street 1:1425 BROADWAY
Practice Address - Street 2:SUITE #2
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-3458
Practice Address - Country:US
Practice Address - Phone:650-342-6817
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35755106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist