Healthcare Provider Details

I. General information

NPI: 1033747035
Provider Name (Legal Business Name): NAMIYO HEMPHILL LE. CPE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 02/13/2026
Certification Date: 02/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24391 AVENIDA DE LA CARLOTA APT 552
LAGUNA HILLS CA
92653-7662
US

IV. Provider business mailing address

24391 AVENIDA DE LA CARLOTA APT 552
LAGUNA HILLS CA
92653-7662
US

V. Phone/Fax

Practice location:
  • Phone: 949-235-7721
  • Fax:
Mailing address:
  • Phone: 949-235-7721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberL8510
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: