Provider Demographics
NPI:1467551911
Name:HAMPTON HOLMES, TAKISHA (FNP)
Entity type:Individual
Prefix:MRS
First Name:TAKISHA
Middle Name:
Last Name:HAMPTON HOLMES
Suffix:
Gender:
Credentials:FNP
Other - Prefix:MS
Other - First Name:TAKISHA
Other - Middle Name:LASHAN
Other - Last Name:HAMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:5132 ARLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-1944
Mailing Address - Country:US
Mailing Address - Phone:562-805-9586
Mailing Address - Fax:
Practice Address - Street 1:10300 COMPTON AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90002-3628
Practice Address - Country:US
Practice Address - Phone:323-568-3025
Practice Address - Fax:323-563-3386
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAVN192828164X00000X
CA95033780363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily