Provider Demographics
NPI:1942017033
Name:HAWKINS, CLARA
Entity type:Individual
Prefix:
First Name:CLARA
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CLARA
Other - Middle Name:
Other - Last Name:SAGUTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6530 KOKI LN
Mailing Address - Street 2:
Mailing Address - City:EL DORADO
Mailing Address - State:CA
Mailing Address - Zip Code:95623-4328
Mailing Address - Country:US
Mailing Address - Phone:530-621-4003
Mailing Address - Fax:
Practice Address - Street 1:6530 KOKI LN
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:CA
Practice Address - Zip Code:95623-4328
Practice Address - Country:US
Practice Address - Phone:530-621-4003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-12
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA230212357101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool