Healthcare Provider Details

I. General information

NPI: 1295236560
Provider Name (Legal Business Name): TAMARA LYNNE HOBSON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2018
Last Update Date: 11/21/2024
Certification Date: 11/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11234 ANDERSON ST
LOMA LINDA CA
92354-2804
US

IV. Provider business mailing address

37874 VINELAND ST
CHERRY VALLEY CA
92223-4075
US

V. Phone/Fax

Practice location:
  • Phone: 909-558-2806
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95008502
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95008502
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: