Provider Demographics
NPI:1891892279
Name:HALL, PAULA B (PSYD, MFT)
Entity Type:Individual
Prefix:DR
First Name:PAULA
Middle Name:B
Last Name:HALL
Suffix:
Gender:F
Credentials:PSYD, MFT
Other - Prefix:DR
Other - First Name:PAULA
Other - Middle Name:HALL
Other - Last Name:DUVANDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD, MFT
Mailing Address - Street 1:3164 CONDO CT
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-2557
Mailing Address - Country:US
Mailing Address - Phone:707-360-1908
Mailing Address - Fax:
Practice Address - Street 1:3164 CONDO CT
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-2557
Practice Address - Country:US
Practice Address - Phone:707-360-1908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC31238106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist