Provider Demographics
NPI:1639931991
Name:HASSEN, JOEL
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:HASSEN
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 1:309 WILLOUGHBY CT
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-4123
Mailing Address - Country:US
Mailing Address - Phone:925-330-1582
Mailing Address - Fax:
Practice Address - Street 1:309 WILLOUGHBY CT
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-4123
Practice Address - Country:US
Practice Address - Phone:925-330-1582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty