Provider Demographics
NPI: | 1245769298 |
---|---|
Name: | HUNT, FELICIA LATONYA (NP) |
Entity Type: | Individual |
Prefix: | MS |
First Name: | FELICIA |
Middle Name: | LATONYA |
Last Name: | HUNT |
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: | 22523 ANCHOR AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | CARSON |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 90745-4009 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 714-853-4456 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 22523 ANCHOR AVE |
Practice Address - Street 2: | |
Practice Address - City: | CARSON |
Practice Address - State: | CA |
Practice Address - Zip Code: | 90745-4009 |
Practice Address - Country: | US |
Practice Address - Phone: | 714-853-4456 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2017-06-05 |
Last Update Date: | 2023-08-15 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 95007035 | 363LG0600X, 363LP2300X, 363LA2100X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LA2100X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Acute Care |
No | 363LG0600X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Gerontology |
No | 363LP2300X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care |