MEDICARE: HAJRA HAMID

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1588113633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HAJRA HAMID

Provider Business Mailing Address
First Line	:	8423 PERSIMMON PL
Second Line	:
City	:	NEWARK
State	:	CA
Zip	:	94560-2753
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 CROW CANYON CT
Second Line	:
City	:	SAN RAMON
State	:	CA
Zip	:	94583-1928
Country	:	US
Telephone Number	:	925-263-2085
Fax Number	:

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

Provider Enumeration Date	:	09/30/2016
Last Update Date	:	09/30/2016

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Directions to “ HAJRA HAMID ” Practice Location

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