MEDICARE: DR. DAVID NATHANIEL HAWKEY PSY.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor
2	103TC2200X	Clinical Child & Adolescent Psychologist	PSY26626	CA
3	103TC0700X	Clinical Psychologist	PSY26626	CA

General Provider Information

NPI Number	:	1427179662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID NATHANIEL HAWKEY PSY.D.

Provider Business Mailing Address
First Line	:	1440 BROADWAY
Second Line	:	STE. 314
City	:	OAKLAND
State	:	CA
Zip	:	94612-2041
Country	:	US
Telephone Number	:	415-450-8216
Fax Number	:

Provider Business Practice Location Address
First Line	:	1440 BROADWAY
Second Line	:	STE. 314
City	:	OAKLAND
State	:	CA
Zip	:	94612-2041
Country	:	US
Telephone Number	:	415-450-8216
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2007
Last Update Date	:	01/11/2022

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