Healthcare Provider Details

I. General information

NPI: 1073104204
Provider Name (Legal Business Name): CAMRYN MICHELE HOHNEKER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2021
Last Update Date: 01/30/2021
Certification Date: 01/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6222 E QUARTZ LN
ANAHEIM CA
92807-4833
US

IV. Provider business mailing address

6222 E QUARTZ LN
ANAHEIM CA
92807-4833
US

V. Phone/Fax

Practice location:
  • Phone: 714-474-9829
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: