Provider Demographics
NPI:1891098281
Name:HAMMOND, JOHN MARK (MS, MFT, LEP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MARK
Last Name:HAMMOND
Suffix:
Gender:M
Credentials:MS, MFT, LEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 E CANAL DR
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380-3936
Mailing Address - Country:US
Mailing Address - Phone:209-668-6121
Mailing Address - Fax:209-656-1487
Practice Address - Street 1:440 E CANAL DR
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-3936
Practice Address - Country:US
Practice Address - Phone:209-485-0197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALEP 1342103TS0200X
CAMFC 20086106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool