Healthcare Provider Details

I. General information

NPI: 1013085398
Provider Name (Legal Business Name): PHILIP C HAMMEL PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2006
Last Update Date: 12/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E WASHINGTON AVE #100
ESCONDIDO CA
92025-1806
US

IV. Provider business mailing address

200 E WASHINGTON AVE #100
ESCONDIDO CA
92025-1806
US

V. Phone/Fax

Practice location:
  • Phone: 760-737-8642
  • Fax: 760-737-8918
Mailing address:
  • Phone: 760-737-8642
  • Fax: 760-737-8918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: