Healthcare Provider Details

I. General information

NPI: 1992806426
Provider Name (Legal Business Name): LUCILLE MARY HAMILTON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 04/03/2026
Certification Date: 04/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 PLAZA DR STE 170
FOLSOM CA
95630-4790
US

IV. Provider business mailing address

3050 FITE CIR # 101Y
SACRAMENTO CA
95827-1806
US

V. Phone/Fax

Practice location:
  • Phone: 916-351-9400
  • Fax:
Mailing address:
  • Phone: 530-748-6841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCS15874
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: