Healthcare Provider Details

I. General information

NPI: 1700909082
Provider Name (Legal Business Name): YVONNE CELESTE HANSON LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1460 MARIA LN SUITE 200
WALNUT CREEK CA
94596-8802
US

IV. Provider business mailing address

4887 THIESSEN CT
CONCORD CA
94521-2200
US

V. Phone/Fax

Practice location:
  • Phone: 925-671-0663
  • Fax: 925-671-0663
Mailing address:
  • Phone: 925-671-6827
  • Fax: 925-671-0663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC28459
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: