Provider Demographics
NPI:1386748671
Name:HYMAN, WILLIAM ANDREW (CACDII)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:ANDREW
Last Name:HYMAN
Suffix:
Gender:M
Credentials:CACDII
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1083
Mailing Address - Street 2:
Mailing Address - City:MARNIA
Mailing Address - State:CA
Mailing Address - Zip Code:93933
Mailing Address - Country:US
Mailing Address - Phone:831-578-6179
Mailing Address - Fax:
Practice Address - Street 1:3401 ENGINEER LANE
Practice Address - Street 2:
Practice Address - City:SEASIDE
Practice Address - State:CA
Practice Address - Zip Code:93955
Practice Address - Country:US
Practice Address - Phone:831-883-3804
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARA847404101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)