Provider Demographics
NPI:1649049883
Name:HAMER, CHARLENE ELIZABETH (LMFT 143860)
Entity type:Individual
Prefix:
First Name:CHARLENE
Middle Name:ELIZABETH
Last Name:HAMER
Suffix:
Gender:F
Credentials:LMFT 143860
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2607 ROKEBY ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90039-2620
Mailing Address - Country:US
Mailing Address - Phone:323-552-3796
Mailing Address - Fax:
Practice Address - Street 1:2607 ROKEBY ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90039-2620
Practice Address - Country:US
Practice Address - Phone:323-552-3796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-28
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA143860106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist