Provider Demographics
NPI:1679595748
Name:HAWKINS, WENDY L (LCSW)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:L
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1885 THE ALAMEDA
Mailing Address - Street 2:SUITE 100J
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-1744
Mailing Address - Country:US
Mailing Address - Phone:408-261-1501
Mailing Address - Fax:408-261-1536
Practice Address - Street 1:1885 THE ALAMEDA
Practice Address - Street 2:SUITE 100J
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-1744
Practice Address - Country:US
Practice Address - Phone:408-261-1501
Practice Address - Fax:408-261-1536
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 110421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical