Provider Demographics
NPI:1629529318
Name:HAMRICK, PHILIP
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:
Last Name:HAMRICK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:FIDDLETOWN
Mailing Address - State:CA
Mailing Address - Zip Code:95629-0043
Mailing Address - Country:US
Mailing Address - Phone:707-497-9490
Mailing Address - Fax:
Practice Address - Street 1:601 COURT ST
Practice Address - Street 2:SUITE 100
Practice Address - City:JACKSON
Practice Address - State:CA
Practice Address - Zip Code:95642-2160
Practice Address - Country:US
Practice Address - Phone:209-257-1244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-18
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health