Provider Demographics
NPI:1831335553
Name:HOPE, LANEDA JOYCE
Entity type:Individual
Prefix:
First Name:LANEDA
Middle Name:JOYCE
Last Name:HOPE
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:PO BOX 335
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-0335
Mailing Address - Country:US
Mailing Address - Phone:707-464-2969
Mailing Address - Fax:
Practice Address - Street 1:206 WILLIAMS DR
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-8301
Practice Address - Country:US
Practice Address - Phone:707-464-7224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-30
Last Update Date:2008-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA94-2254126OtherFEDERAL TAX ID #