Healthcare Provider Details

I. General information

NPI: 1568142594
Provider Name (Legal Business Name): JOANNA HAMMER MA, PPS, LEP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOANNA HUNT MA, PPS, LEP

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 07/24/2023
Certification Date: 07/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 FIR ST
TEHACHAPI CA
93561-2310
US

IV. Provider business mailing address

105 FIR ST
TEHACHAPI CA
93561-2310
US

V. Phone/Fax

Practice location:
  • Phone: 661-204-7176
  • Fax:
Mailing address:
  • Phone: 661-204-7176
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number4227
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: