Provider Demographics
NPI:1013083021
Name:HAMMANN, JESSICA ELLEN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ELLEN
Last Name:HAMMANN
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 1:126 PINE ST
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:MA
Mailing Address - Zip Code:02493-1161
Mailing Address - Country:US
Mailing Address - Phone:781-899-6481
Mailing Address - Fax:
Practice Address - Street 1:126 PINE ST
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:MA
Practice Address - Zip Code:02493-1161
Practice Address - Country:US
Practice Address - Phone:781-899-6481
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2010-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA916 PSY HEALTH SERVI103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
051572000OtherMAGELLAN BEHAVIORAL HEALT
MA411624OtherTUFTS
MAW01447OtherBLUE CROSS BLUE SHIELD
MA411624OtherTUFTS