Provider Demographics
NPI:1588237010
Name:HANKERD, KERI LORRAINE
Entity Type:Individual
Prefix:
First Name:KERI
Middle Name:LORRAINE
Last Name:HANKERD
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 1:377 E PEARL ST APT 2
Mailing Address - Street 2:
Mailing Address - City:POMONA
Mailing Address - State:CA
Mailing Address - Zip Code:91767-4758
Mailing Address - Country:US
Mailing Address - Phone:626-482-8554
Mailing Address - Fax:
Practice Address - Street 1:377 E PEARL ST APT 2
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-4758
Practice Address - Country:US
Practice Address - Phone:626-482-8554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty