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NPI Code Detail

MEDICARE: BROOKE ELIZABETH HATHAWAY

MEDICARE: BROOKE ELIZABETH HATHAWAY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YS0200XSchool CounselorCA

General Provider Information

NPI Number : 1730016197
Entity Type Code : Individual
Provider Name (Legal Business Name) : BROOKE ELIZABETH HATHAWAY
Provider Business Mailing Address
First Line : 8945 GOLF LINKS RD
Second Line :
City : OAKLAND
State : CA
Zip : 94605-4124
Country : US
Telephone Number : 510-317-1444
Fax Number :
Provider Business Practice Location Address
First Line : 8945 GOLF LINKS RD
Second Line :
City : OAKLAND
State : CA
Zip : 94605-4124
Country : US
Telephone Number : 510-317-1444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/07/2026
Last Update Date : 05/07/2026

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Directions to “ BROOKE ELIZABETH HATHAWAY ” Practice Location

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