MEDICARE: AIMEE L HAMMOND RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian
2	133NN1002X	Nutrition Education Nutritionist

General Provider Information

NPI Number	:	1104115799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIMEE L HAMMOND RD

Provider Business Mailing Address
First Line	:	8752 DENVER ST
Second Line	:
City	:	VENTURA
State	:	CA
Zip	:	93004-2535
Country	:	US
Telephone Number	:	805-746-3657
Fax Number	:

Provider Business Practice Location Address
First Line	:	123 HODENCAMP RD STE 103
Second Line	:
City	:	THOUSAND OAKS
State	:	CA
Zip	:	91360-5833
Country	:	US
Telephone Number	:	805-746-3657
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2011
Last Update Date	:	09/16/2024

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