Provider Demographics
NPI:1477954543
Name:HAMPTON, DEBRA BRENNETTE
Entity Type:Individual
Prefix:
First Name:DEBRA
Middle Name:BRENNETTE
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4043 WEST BLVD
Mailing Address - Street 2:APT B
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90008-3130
Mailing Address - Country:US
Mailing Address - Phone:213-488-9559
Mailing Address - Fax:213-683-0969
Practice Address - Street 1:526 S SAN PEDRO ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90013-2102
Practice Address - Country:US
Practice Address - Phone:213-488-9559
Practice Address - Fax:213-683-0969
Is Sole Proprietor?:No
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator