Healthcare Provider Details
I. General information
NPI: 1780367383
Provider Name (Legal Business Name): EMILY HAMOCON RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/09/2023
Last Update Date: 11/28/2024
Certification Date: 11/28/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1444 N POINSETTIA PL
LOS ANGELES CA
90046-4364
US
IV. Provider business mailing address
427 MONTANA AVE APT 18
SANTA MONICA CA
90403-1324
US
V. Phone/Fax
- Phone: 808-542-5131
- Fax:
- Phone: 818-804-8056
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133VN1006X |
| Taxonomy | Metabolic Nutrition Registered Dietitian |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133VN1004X |
| Taxonomy | Pediatric Nutrition Registered Dietitian |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133VN1005X |
| Taxonomy | Renal Nutrition Registered Dietitian |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133VN1101X |
| Taxonomy | Gerontological Nutrition Registered Dietitian |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133V00000X |
| Taxonomy | Registered Dietitian |
| License Number | 86393079 |
| License Number State | CA |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133VN1201X |
| Taxonomy | Obesity and Weight Management Nutrition Registered Dietitian |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133VN1301X |
| Taxonomy | Oncology Nutrition Registered Dietitian |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 133VN1501X |
| Taxonomy | Sports Dietetics Nutrition Registered Dietitian |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: