Provider Demographics
NPI:1497025464
Name:HOSTETLER, MARY ALICE
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:ALICE
Last Name:HOSTETLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 CONSTITUTION BLVD
Mailing Address - Street 2:BLDG. 400 - SUITE 200
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93906-3100
Mailing Address - Country:US
Mailing Address - Phone:831-755-5513
Mailing Address - Fax:
Practice Address - Street 1:1441 CONSTITUTION BLVD
Practice Address - Street 2:BLDG. 400 - SUITE 200
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93906-3100
Practice Address - Country:US
Practice Address - Phone:831-755-5513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health