Healthcare Provider Details

I. General information

NPI: 1467551911
Provider Name (Legal Business Name): TAKISHA HAMPTON HOLMES FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TAKISHA LASHAN HAMPTON LVN

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 04/10/2025
Certification Date: 04/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10300 COMPTON AVE
LOS ANGELES CA
90002-3628
US

IV. Provider business mailing address

5132 ARLINGTON AVE
LOS ANGELES CA
90043-1944
US

V. Phone/Fax

Practice location:
  • Phone: 323-568-3025
  • Fax: 323-563-3386
Mailing address:
  • Phone: 562-805-9586
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95033780
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN192828
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: