Provider Demographics
NPI:1639407653
Name:HEWES, TIMOTHY VIRGIL (MFT)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:VIRGIL
Last Name:HEWES
Suffix:
Gender:M
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:PO BOX 180
Mailing Address - Street 2:
Mailing Address - City:KEENE
Mailing Address - State:CA
Mailing Address - Zip Code:93531-0180
Mailing Address - Country:US
Mailing Address - Phone:661-204-8948
Mailing Address - Fax:
Practice Address - Street 1:113 E F ST
Practice Address - Street 2:
Practice Address - City:TEHACHAPI
Practice Address - State:CA
Practice Address - Zip Code:93561-1710
Practice Address - Country:US
Practice Address - Phone:661-822-8223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-02
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 018365106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist