Provider Demographics
NPI:1679359269
Name:HAWKINS, ARVEAL
Entity Type:Individual
Prefix:
First Name:ARVEAL
Middle Name:
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 1:24135 HIBISCUS LN
Mailing Address - Street 2:
Mailing Address - City:LAKE ELSINORE
Mailing Address - State:CA
Mailing Address - Zip Code:92532-2716
Mailing Address - Country:US
Mailing Address - Phone:951-852-1516
Mailing Address - Fax:
Practice Address - Street 1:41689 ENTERPRISE CIR N STE 120
Practice Address - Street 2:
Practice Address - City:TEMECULA
Practice Address - State:CA
Practice Address - Zip Code:92590-5630
Practice Address - Country:US
Practice Address - Phone:951-587-4165
Practice Address - Fax:951-384-0544
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-07
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA372500000X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No372500000XNursing Service Related ProvidersChore Provider