Provider Demographics
NPI:1386152189
Name:GAMMON, HANNAH (PSYD)
Entity type:Individual
Prefix:DR
First Name:HANNAH
Middle Name:
Last Name:GAMMON
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8549 WILSHIRE BLVD STE 5043
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-3104
Mailing Address - Country:US
Mailing Address - Phone:424-278-9724
Mailing Address - Fax:
Practice Address - Street 1:8549 WILSHIRE BLVD STE 5043
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-3104
Practice Address - Country:US
Practice Address - Phone:424-278-9724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-15
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPSY.0004344103TC0700X
CAPSY33908103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical