Healthcare Provider Details

I. General information

NPI: 1356061857
Provider Name (Legal Business Name): ERIN ELIZABETH HANNON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ERIN HANNON

II. Dates (important events)

Enumeration Date: 09/02/2022
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 MONTGOMERY ST STE 204
SAN FRANCISCO CA
94104-1904
US

IV. Provider business mailing address

300 MONTGOMERY ST STE 204
SAN FRANCISCO CA
94104-1904
US

V. Phone/Fax

Practice location:
  • Phone: 415-202-5159
  • Fax:
Mailing address:
  • Phone: 415-202-5159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number136298
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: