Provider Demographics
NPI:1538179973
Name:HAMNER, CAROLINE SPENCER (MFT)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:SPENCER
Last Name:HAMNER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32032 VIRGINIA WAY
Mailing Address - Street 2:
Mailing Address - City:LAGUNA BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92651-6815
Mailing Address - Country:US
Mailing Address - Phone:949-581-7400
Mailing Address - Fax:949-770-7541
Practice Address - Street 1:22600 LAMBERT ST # B
Practice Address - Street 2:SUITE 802
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630-6201
Practice Address - Country:US
Practice Address - Phone:949-581-7400
Practice Address - Fax:949-770-7541
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT 34564106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist