Provider Demographics
NPI:1881843415
Name:HINTON-BORN, NICOLE (MFT)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:
Last Name:HINTON-BORN
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 1:160 SHRADER ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94117-1017
Mailing Address - Country:US
Mailing Address - Phone:415-407-5964
Mailing Address - Fax:415-422-0882
Practice Address - Street 1:2166 HAYES ST
Practice Address - Street 2:SUITE 208
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1033
Practice Address - Country:US
Practice Address - Phone:415-407-5964
Practice Address - Fax:415-407-5964
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-18
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 46217101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health