Provider Demographics
NPI:1477931939
Name:HAMM, TRICIA ILENE (LMFT)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:ILENE
Last Name:HAMM
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 W LANCASTER BLVD STE 115
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-2303
Mailing Address - Country:US
Mailing Address - Phone:661-903-8822
Mailing Address - Fax:661-231-3143
Practice Address - Street 1:815 W LANCASTER BLVD STE 115
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2303
Practice Address - Country:US
Practice Address - Phone:661-903-8822
Practice Address - Fax:661-231-3143
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-15
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA109281106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA#95-2633765OtherMEDI-CAL