Provider Demographics
NPI:1659017648
Name:HOBAN, WILLIAM GORDON (MA,PSYCHOLOGY)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:GORDON
Last Name:HOBAN
Suffix:
Gender:M
Credentials:MA,PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2619 SPRING OAKS DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-9137
Mailing Address - Country:US
Mailing Address - Phone:805-630-0911
Mailing Address - Fax:
Practice Address - Street 1:2619 SPRING OAKS DR
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-9137
Practice Address - Country:US
Practice Address - Phone:805-630-0911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-11
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT25572101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)