Provider Demographics
NPI:1134270226
Name:HEWITT, MICHAEL GIRARD (PSYD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GIRARD
Last Name:HEWITT
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:500 S ANAHEIM HILLS RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92807-4780
Mailing Address - Country:US
Mailing Address - Phone:714-403-7867
Mailing Address - Fax:714-276-0413
Practice Address - Street 1:500 S ANAHEIM HILLS RD
Practice Address - Street 2:SUITE 202
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92807-4780
Practice Address - Country:US
Practice Address - Phone:714-403-7867
Practice Address - Fax:714-276-0413
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2008-01-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPSY16699103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical