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NPI Code Detail

MEDICARE: MR. CHRISTOPHER WILLIAM HAUCK LCSW

MEDICARE: MR. CHRISTOPHER WILLIAM HAUCK LCSW
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
1101YM0800XMental Health Counselor
21041C0700XClinical Social Worker

General Provider Information

NPI Number : 1487886883
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CHRISTOPHER WILLIAM HAUCK LCSW
Provider Business Mailing Address
First Line : 5855 SILVER CREEK VALLEY PLACE
Second Line :
City : SAN JOSE
State : CA
Zip : 95138-1059
Country : US
Telephone Number : 408-574-9100
Fax Number :
Provider Business Practice Location Address
First Line : 5855 SILVER CREEK VALLEY PLACE
Second Line :
City : SAN JOSE
State : CA
Zip : 95138-1059
Country : US
Telephone Number : 408-574-9100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2009
Last Update Date : 07/29/2019

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