Provider Demographics
NPI:1043805047
Name:HAMMAN, RAELYN NICOLE (NP-C)
Entity Type:Individual
Prefix:
First Name:RAELYN
Middle Name:NICOLE
Last Name:HAMMAN
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:RAELYN
Other - Middle Name:NICOLE
Other - Last Name:FERRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8035 SANTA ROSA RD
Mailing Address - Street 2:
Mailing Address - City:ATASCADERO
Mailing Address - State:CA
Mailing Address - Zip Code:93422-4941
Mailing Address - Country:US
Mailing Address - Phone:408-202-4130
Mailing Address - Fax:
Practice Address - Street 1:612 MEIGS RD
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93109-1517
Practice Address - Country:US
Practice Address - Phone:408-202-4130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-02
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95016823363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily