Provider Demographics
NPI:1245307891
Name:HISCOX, ANNA RENEE (LMFT)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:RENEE
Last Name:HISCOX
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 JEFFERSON ST
Mailing Address - Street 2:#203
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533-5511
Mailing Address - Country:US
Mailing Address - Phone:707-425-0633
Mailing Address - Fax:707-437-0495
Practice Address - Street 1:711 JEFFERSON ST
Practice Address - Street 2:#203
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-5511
Practice Address - Country:US
Practice Address - Phone:707-425-0633
Practice Address - Fax:707-437-0495
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39870106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist