Provider Demographics
NPI:1821417809
Name:HAMILTON, ERIC
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:
Last Name:HAMILTON
Suffix:
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 1:12966 EUCLID ST
Mailing Address - Street 2:SUITE 280
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92840-5200
Mailing Address - Country:US
Mailing Address - Phone:714-823-4770
Mailing Address - Fax:
Practice Address - Street 1:12966 EUCLID ST
Practice Address - Street 2:SUITE 280
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92840-5200
Practice Address - Country:US
Practice Address - Phone:714-823-4770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-07
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health