Healthcare Provider Details

I. General information

NPI: 1508727744
Provider Name (Legal Business Name): MS. HANNAH LYNN PLOTKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2025
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 17TH ST APT 4
SANTA MONICA CA
90403-3229
US

IV. Provider business mailing address

932 17TH ST APT 4
SANTA MONICA CA
90403-3229
US

V. Phone/Fax

Practice location:
  • Phone: 310-985-3628
  • Fax:
Mailing address:
  • Phone: 310-985-3628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: