Basic Information
| Provider Information | |||||||||
| NPI: | 1528676160 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MULLIGAN | ||||||||
| FirstName: | HOPE | ||||||||
| MiddleName: | LYNN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 516 PINE GARDEN LN APT H | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958255542 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2318382516 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2750 SUTTERVILLE RD # COTTAGE1 | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958201024 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164523981 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2020 | ||||||||
| LastUpdateDate: | 11/10/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | N | Behavioral Health & Social Service Providers | Counselor | 104100000X | 194602 | CA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.