Healthcare Provider Details

I. General information

NPI: 1710123872
Provider Name (Legal Business Name): ELIZABETH SARAH HAMMER PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELIZABETH SARAH FINKE

II. Dates (important events)

Enumeration Date: 12/19/2008
Last Update Date: 03/24/2021
Certification Date: 03/24/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6735 DECANTURE ST
SAN DIEGO CA
92120
US

IV. Provider business mailing address

5173 WARING ROAD SUITE A, #5
SAN DIEGO CA
92120
US

V. Phone/Fax

Practice location:
  • Phone: 619-255-8954
  • Fax: 619-255-8954
Mailing address:
  • Phone: 619-306-5727
  • Fax: 619-528-4625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY24827
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberPSB33458
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: