Provider Demographics
NPI:1609646900
Name:HAWKINS, ASHLEY TAMARA
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:TAMARA
Last Name:HAWKINS
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 1:706 MCDONALD AVE APT 314
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-5364
Mailing Address - Country:US
Mailing Address - Phone:310-579-5471
Mailing Address - Fax:
Practice Address - Street 1:706 MCDONALD AVE APT 314
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-5364
Practice Address - Country:US
Practice Address - Phone:310-579-5471
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)