Provider Demographics
NPI:1720290919
Name:HAWKINS, CLARENCE DARROW II
Entity Type:Individual
Prefix:
First Name:CLARENCE
Middle Name:DARROW
Last Name:HAWKINS
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 WEST GAGE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90044
Mailing Address - Country:US
Mailing Address - Phone:213-487-0687
Mailing Address - Fax:213-207-2773
Practice Address - Street 1:537 S ALVARADO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90057-2903
Practice Address - Country:US
Practice Address - Phone:213-487-0687
Practice Address - Fax:213-207-2773
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)