Provider Demographics
NPI:1851452874
Name:HOKANSON, CAROLYN FEYDER (PHD)
Entity Type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:FEYDER
Last Name:HOKANSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1855 SAN MIGUEL DR
Mailing Address - Street 2:SUITE 11
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596
Mailing Address - Country:US
Mailing Address - Phone:925-932-1270
Mailing Address - Fax:925-935-8545
Practice Address - Street 1:1855 SAN MIGUEL DR
Practice Address - Street 2:SUITE 11
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596
Practice Address - Country:US
Practice Address - Phone:925-932-1270
Practice Address - Fax:925-935-8545
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7215103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
00PL72150Medicare ID - Type Unspecified