Provider Demographics
NPI:1922779453
Name:HAWLEY, KATHRYN J (PHD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:J
Last Name:HAWLEY
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 1:2010 EL CAMINO REAL
Mailing Address - Street 2:PMB 3136
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95050-4051
Mailing Address - Country:US
Mailing Address - Phone:415-962-6404
Mailing Address - Fax:
Practice Address - Street 1:740 FRONT ST STE 220
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-4536
Practice Address - Country:US
Practice Address - Phone:831-999-3524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-23
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32827103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical