Provider Demographics
NPI:1194888362
Name:HAHN, MICHAEL (MICHAEL HAHN)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:HAHN
Suffix:
Gender:M
Credentials:MICHAEL HAHN
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:HAHN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MICHAEL HAHN, PHD
Mailing Address - Street 1:780 WELCH RD
Mailing Address - Street 2:207
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-1516
Mailing Address - Country:US
Mailing Address - Phone:650-321-0365
Mailing Address - Fax:650-321-3460
Practice Address - Street 1:780 WELCH RD
Practice Address - Street 2:207
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94304-1516
Practice Address - Country:US
Practice Address - Phone:650-321-0365
Practice Address - Fax:650-321-3460
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY3490103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist