# HAZEL HAWKINS MEMORIAL HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Other names:** HAZEL HAWKINS CONV. HOSPITAL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1467585471
- **Authorized official:** MRS. MARY CASILLAS (CHIEF FINANCIAL OFFICER)
- **Authorized official phone:** (831) 636-2604

## Contact information

- **Practice address:** 911 SUNSET DR, HOLLISTER, CA 95023-5602
- **Practice address phone:** (831) 637-5711
- **Practice address fax:** (831) 637-3126
- **Mailing address:** 911 SUNSET DR, HOLLISTER, CA 95023-5602
- **Mailing address phone:** (831) 637-5711
- **Mailing address fax:** (831) 637-3126

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 314000000X | Skilled Nursing Facility | 070000004 | CA | Yes |

## Other

- **Enumeration date:** 03/13/2007
- **Last updated:** 01/11/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | ZZR05462F | — | CA |