Provider Demographics
NPI:1881725596
Name:HALL, CASSANDRA J (MS, MFT)
Entity type:Individual
Prefix:MRS
First Name:CASSANDRA
Middle Name:J
Last Name:HALL
Suffix:
Gender:F
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1834
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93539-1834
Mailing Address - Country:US
Mailing Address - Phone:661-492-7508
Mailing Address - Fax:
Practice Address - Street 1:42455 10TH ST W STE 103
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-7060
Practice Address - Country:US
Practice Address - Phone:661-341-3900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45639106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist