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General NPI Number Information
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NPI Number | 1811801996
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Entity Type | Individual
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Provider Name | HASSAN MALIK HERCULES-BARNETT
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Gender | Male
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Dates
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Enumeration Date | 09/28/2026
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Last Update Date | 09/28/2026
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Provider Practice Location Address
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Address Line | 1560 BROOKHOLLOW DR STE 106
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City | SANTA ANA
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State | CA
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Zip | 92705-5428
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Country | US
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Telephone | 657-298-2321
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Fax |
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Provider Business Mailing Address
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Address Line | 588 W BAY ST
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City | COSTA MESA
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State | CA
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Zip | 92627-2607
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Country | US
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Telephone | 310-213-2960
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | APCC20102
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT156725
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License Number State | CA
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