Healthcare Provider Details

I. General information

NPI: 1013827146
Provider Name (Legal Business Name): TREVOR HAMMONS MA PPSC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2026
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1720 M ST
ARCATA CA
95521-5741
US

IV. Provider business mailing address

1720 M ST
ARCATA CA
95521-5741
US

V. Phone/Fax

Practice location:
  • Phone: 707-825-2445
  • Fax:
Mailing address:
  • Phone: 707-825-2445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: