Basic Information
| Provider Information | |||||||||
| NPI: | 1114410297 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAMMER | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | SUE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1047 N FULTON ST APT 6 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937283438 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6026388834 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2416 W SHAW AVE STE 114 | ||||||||
| Address2: | |||||||||
| City: | FRESNO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 937113303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5595584051 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2018 | ||||||||
| LastUpdateDate: | 12/06/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | N | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 171M00000X | Y | Other Service Providers | Case Manager/Care Coordinator |
No ID Information.