Provider Demographics
NPI:1043990237
Name:HAMORY, MARLIS JULIET (NP)
Entity Type:Individual
Prefix:
First Name:MARLIS
Middle Name:JULIET
Last Name:HAMORY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1814 OLIVE AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-1023
Mailing Address - Country:US
Mailing Address - Phone:802-734-4330
Mailing Address - Fax:
Practice Address - Street 1:1814 OLIVE AVE
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1023
Practice Address - Country:US
Practice Address - Phone:802-734-4330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-21
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95026688363LF0000X
CA796834163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily