Provider Demographics
NPI:1679854053
Name:HINKENS, VICKI LYNNE (MFT)
Entity Type:Individual
Prefix:MS
First Name:VICKI
Middle Name:LYNNE
Last Name:HINKENS
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 S. B ST.
Mailing Address - Street 2:
Mailing Address - City:LOMPOC
Mailing Address - State:CA
Mailing Address - Zip Code:93436-9742
Mailing Address - Country:US
Mailing Address - Phone:805-735-4376
Mailing Address - Fax:805-737-3251
Practice Address - Street 1:101 S B ST
Practice Address - Street 2:
Practice Address - City:LOMPOC
Practice Address - State:CA
Practice Address - Zip Code:93436-6933
Practice Address - Country:US
Practice Address - Phone:805-735-4376
Practice Address - Fax:805-737-3251
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2017-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT47895106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist