Provider Demographics
NPI:1497988117
Name:HAMPTON, LATOYA A
Entity Type:Individual
Prefix:MS
First Name:LATOYA
Middle Name:A
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 1:3680 E IMPERIAL HWY
Mailing Address - Street 2:SUITE 520
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-2659
Mailing Address - Country:US
Mailing Address - Phone:323-497-0710
Mailing Address - Fax:
Practice Address - Street 1:3680 E IMPERIAL HWY
Practice Address - Street 2:SUITE 520
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-2659
Practice Address - Country:US
Practice Address - Phone:323-497-0710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-27
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29381101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health