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General NPI Number Information
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NPI Number | 1497164230
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Entity Type | Individual
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Provider Name | GREGORY HAMILTON
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Gender | Male
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Dates
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Enumeration Date | 08/06/2014
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Last Update Date | 12/29/2015
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Provider Practice Location Address
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Address Line | 9465 FARNHAM ST
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City | SAN DIEGO
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State | CA
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Zip | 92123-1308
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Country | US
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Telephone | 619-948-3708
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Fax |
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Provider Business Mailing Address
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Address Line | 1104 CORTE PRIMAVERA
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City | CHULA VISTA
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State | CA
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Zip | 91910-7012
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Country | US
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Telephone | 619-948-3708
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YP1600X
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Taxonomy Name | Pastoral Counselor
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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