Provider Demographics
NPI:1811156078
Name:HANCOCK, RISE DANIELLE (LMFT)
Entity type:Individual
Prefix:MS
First Name:RISE
Middle Name:DANIELLE
Last Name:HANCOCK
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 1:2626 N CALIFORNIA ST
Mailing Address - Street 2:SUITE J
Mailing Address - City:STOCKTON
Mailing Address - State:CA
Mailing Address - Zip Code:95204-5500
Mailing Address - Country:US
Mailing Address - Phone:209-938-0831
Mailing Address - Fax:209-938-0849
Practice Address - Street 1:2626 N CALIFORNIA ST
Practice Address - Street 2:SUITE J
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-5500
Practice Address - Country:US
Practice Address - Phone:209-938-0831
Practice Address - Fax:209-938-0849
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-03
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC32184106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist