MEDICARE: MS. ANN HAWKINS

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

General Provider Information

NPI Number	:	1942572839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANN HAWKINS

Provider Business Mailing Address
First Line	:	2321 GRANT ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94703-1715
Country	:	US
Telephone Number	:	510-417-1141
Fax Number	:

Provider Business Practice Location Address
First Line	:	2321 GRANT ST
Second Line	:
City	:	BERKELEY
State	:	CA
Zip	:	94703-1715
Country	:	US
Telephone Number	:	510-417-1141
Fax Number	:

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

Provider Enumeration Date	:	02/07/2012
Last Update Date	:	02/07/2012

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