Provider Demographics
NPI:1386321107
Name:FORD, HANNAH LINDSEY (RADT-1)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:LINDSEY
Last Name:FORD
Suffix:
Gender:F
Credentials:RADT-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 OHIO ST
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94590-5049
Mailing Address - Country:US
Mailing Address - Phone:707-644-2577
Mailing Address - Fax:
Practice Address - Street 1:126 OHIO ST
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94590-5049
Practice Address - Country:US
Practice Address - Phone:707-644-2577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)