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General NPI Number Information
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NPI Number | 1518100874
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Entity Type | Individual
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Provider Name | MARCY HAWKINS CADC-II, ICADC, CCGC
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Gender | Female
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Dates
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Enumeration Date | 04/15/2009
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Last Update Date | 10/14/2013
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Provider Practice Location Address
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Address Line | 440 BOULDER CT SUITE 100-B
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City | PLEASANTON
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State | CA
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Zip | 94566-8314
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Country | US
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Telephone | 925-426-0501
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Fax | 925-426-0506
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Provider Business Mailing Address
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Address Line | PO BOX 5217
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City | PLEASANTON
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State | CA
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Zip | 94566-0417
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Country | US
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Telephone | 925-426-0501
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Fax | 925-426-0506
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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 | A3813198
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License Number State | CA
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