Provider Demographics
NPI:1922788587
Name:HAWKINS, TOBIAS III (RDAT)
Entity Type:Individual
Prefix:
First Name:TOBIAS
Middle Name:
Last Name:HAWKINS
Suffix:III
Gender:M
Credentials:RDAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:499 MERRITT AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94610-5146
Mailing Address - Country:US
Mailing Address - Phone:510-712-8363
Mailing Address - Fax:
Practice Address - Street 1:2323 HEARST AVE
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94709-1319
Practice Address - Country:US
Practice Address - Phone:510-548-7270
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAR1511620623101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)