Provider Demographics
NPI:1922581446
Name:HAMILTON, JEAN G (MFT)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:G
Last Name:HAMILTON
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 1:560 OXFORD AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-1139
Mailing Address - Country:US
Mailing Address - Phone:650-493-2484
Mailing Address - Fax:
Practice Address - Street 1:560 OXFORD AVE STE 5
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1139
Practice Address - Country:US
Practice Address - Phone:650-493-2484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22237101YM0800X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health