Provider Demographics
NPI:1306961644
Name:HAMILTON, ANITA H (PHD)
Entity type:Individual
Prefix:DR
First Name:ANITA
Middle Name:H
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020 OLD RANCH PKWY STE 328
Mailing Address - Street 2:
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-2751
Mailing Address - Country:US
Mailing Address - Phone:562-477-5674
Mailing Address - Fax:
Practice Address - Street 1:3020 OLD RANCH PKWY STE 328
Practice Address - Street 2:
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-2751
Practice Address - Country:US
Practice Address - Phone:562-477-5674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY21241103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist