Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner | 44177 | CA |
NPI | 1003008210 |
---|---|
Provider Name | Ms. Loyce Ann Hampson |
First Address | Pomona, CA 91767-1906 |
Second Address | Pomona, CA 91767-1906 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2007 |
Last Update Date | 23/01/2008 |