Provider Demographics
NPI:1578116604
Name:HAMMON, ALISON JEAN
Entity Type:Individual
Prefix:
First Name:ALISON
Middle Name:JEAN
Last Name:HAMMON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ALISON
Other - Middle Name:JEAN
Other - Last Name:WIGGAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4255 ALAMOS AVE
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93619-5278
Mailing Address - Country:US
Mailing Address - Phone:559-493-8717
Mailing Address - Fax:
Practice Address - Street 1:2823 FRESNO ST
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93721-1324
Practice Address - Country:US
Practice Address - Phone:559-459-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-17
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13695225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist