HOLLY HAMMACK (LCSW) – Clinical Social Worker, NPI 1295939338

HOLLY HAMMACK (LCSW) is a healthcare provider. based in Fontana, California. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. LCS10042 (CA). The NPI Number for HOLLY HAMMACK (LCSW) is 1295939338

Main info

Female
46 Years Of Experience
Name
HOLLY HAMMACK (LCSW)
NPI
1295939338
Phone
(909) 427-3910
Address
9961 SIERRA AVE
Enumeration Date
13 June 2007
Last Update Date
15 September 2008

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9099313388
Graduation Year
1980 (46 years ago)
PAC ID
7719168970
Group Practice PAC ID
4385725266
Professional Enrollment ID
I20110221000707
Address ID
CA917868516UP585XXAVEX403
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

4,987 CLINICAL SOCIAL WORKER in CA

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Provider Addresses for HOLLY HAMMACK (LCSW)

  • Kaiser Permanente Fontana Medical Center, 9961, Sierra Avenue, Fontana, San Bernardino County, California, 92335, United States

    FONTANA, CA 923356720

    Phone: (909) 427-3910

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-02-21

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110221000707IClinical Social WorkerCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 92335)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4385725266View full group profile
NameSpecialtyState
-CA
P S Y C H I A T R YCA
P S Y C H I A T R YCA

Reviews

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Frequently asked questions

Does HOLLY HAMMACK (LCSW) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — HOLLY HAMMACK (LCSW) uses 1295939338.
Is HOLLY HAMMACK (LCSW) still practicing?
HOLLY HAMMACK (LCSW) is currently listed as active in the public NPI registry.
What is HOLLY HAMMACK (LCSW)'s specialty?
The listing groups HOLLY HAMMACK (LCSW) with Clinical Social Worker. Clinical services aligned with this taxonomy classification.
What address line appears for HOLLY HAMMACK (LCSW)?
HOLLY HAMMACK (LCSW)'s geographic hint is Fontana, California in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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