Provider Demographics
NPI:1497438386
Name:HORNE, MAAME-MENSIMA (ND)
Entity type:Individual
Prefix:DR
First Name:MAAME-MENSIMA
Middle Name:
Last Name:HORNE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1535 HARVARD ST APT D
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-5561
Mailing Address - Country:US
Mailing Address - Phone:480-696-9586
Mailing Address - Fax:
Practice Address - Street 1:10474 SANTA MONICA BLVD STE 305
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6931
Practice Address - Country:US
Practice Address - Phone:310-596-5480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAND1527175F00000X
IL227.022863225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist