Provider Demographics
NPI:1548897077
Name:HARE, EMMA (DO)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:
Last Name:HARE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2230 STOCKTON BLVD RM 202
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-1353
Mailing Address - Country:US
Mailing Address - Phone:916-734-7523
Mailing Address - Fax:916-734-3384
Practice Address - Street 1:2230 STOCKTON BLVD RM 202
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-1353
Practice Address - Country:US
Practice Address - Phone:916-734-7523
Practice Address - Fax:916-734-3384
Is Sole Proprietor?:No
Enumeration Date:2020-03-25
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A198392084P0800X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry