Individual
LISA HAMILTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPCC
Contact information
Practice address
129 GREENFIELD AVE, SAN RAFAEL, CA 94901-2622
(415) 420-3282
Mailing address
910 D ST UNIT 151477, SAN RAFAEL, CA 94915-5718
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
LPC-10947
AZ
101YP2500X
Professional Counselor
Primary
LPCC4894
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LPC-10947
ARIZONA BOARD OF BEHAVIORAL HEALTH EXAMINERS
AZ
01
—
LPCC4894
CALIFORNIA BOARD OF BEHAVIORAL SCIENCES
CA
Enumeration date
03/17/2018
Last updated
03/17/2018
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