Healthcare Provider Details

I. General information

NPI: 1285543041
Provider Name (Legal Business Name): SUSAN BOLGER HAMAR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5475 E LA PALMA AVE STE 200
ANAHEIM CA
92807-2075
US

IV. Provider business mailing address

1518 N RAYMOND AVE
FULLERTON CA
92831-2054
US

V. Phone/Fax

Practice location:
  • Phone: 949-722-7118
  • Fax:
Mailing address:
  • Phone: 714-330-5248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: