Individual
MR. TYLER DAVID HAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1131 COMMUNITY PKWY, HOLLISTER, CA 95023
(209) 478-2407
Mailing address
999 PORTER AVE APT 12, STOCKTON, CA 95207-4277
(209) 815-8815
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
171M00000X
Case Manager/Care Coordinator
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
05/10/2019
Last updated
08/05/2025
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