Provider Demographics
NPI:1437785342
Name:HAMMONDS, PHYLICIA RAQUEL (ND)
Entity Type:Individual
Prefix:DR
First Name:PHYLICIA
Middle Name:RAQUEL
Last Name:HAMMONDS
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:770 S GRAND AVE APT 5077
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-3949
Mailing Address - Country:US
Mailing Address - Phone:310-962-0424
Mailing Address - Fax:
Practice Address - Street 1:99 N LA CIENEGA BLVD STE 109
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2286
Practice Address - Country:US
Practice Address - Phone:310-360-7584
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-23
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND1143175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes175F00000XOther Service ProvidersNaturopathGroup - Single Specialty