MEDICARE: DR. LINDA HAMMOND PHD, MFT

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	106H00000X	Marriage & Family Therapist	MFC24047	CA

General Provider Information

NPI Number	:	1710050711
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LINDA HAMMOND PHD, MFT

Provider Business Mailing Address
First Line	:	1202 MORENA BLVD
Second Line	:	STE. 300
City	:	SAN DIEGO
State	:	CA
Zip	:	92110-3841
Country	:	US
Telephone Number	:	619-275-0822
Fax Number	:	619-275-1422

Provider Business Practice Location Address
First Line	:	591 CAMINO DE LA REINA
Second Line	:	STE. 918
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3102
Country	:	US
Telephone Number	:	858-729-9986
Fax Number	:	858-456-1380

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

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	07/08/2007

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