Provider Demographics
NPI:1891820718
Name:HAMPTON, RONDA L (PHD)
Entity Type:Individual
Prefix:
First Name:RONDA
Middle Name:L
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23441 GOLDEN SPRINGS DR # 115
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-2030
Mailing Address - Country:US
Mailing Address - Phone:909-860-0844
Mailing Address - Fax:909-860-1907
Practice Address - Street 1:402 S PROSPECTORS RD # B
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91765-1659
Practice Address - Country:US
Practice Address - Phone:909-860-0844
Practice Address - Fax:909-860-1907
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY17014103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0PL170140Medicare UPIN