Provider Demographics
NPI:1932258902
Name:HUNTER, NATHAN (PHD)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:
Last Name:HUNTER
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:DR
Other - First Name:NATHAN
Other - Middle Name:
Other - Last Name:HUNTER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:23832 ROCKFIELD BLVD
Mailing Address - Street 2:#150
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630
Mailing Address - Country:US
Mailing Address - Phone:949-540-4010
Mailing Address - Fax:
Practice Address - Street 1:23832 ROCKFIELD BLVD
Practice Address - Street 2:#150
Practice Address - City:LAKE FOREST
Practice Address - State:CA
Practice Address - Zip Code:92630
Practice Address - Country:US
Practice Address - Phone:949-540-4010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY15163103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical