Healthcare Provider Details

I. General information

NPI: 1104115799
Provider Name (Legal Business Name): AIMEE L HAMMOND RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2011
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

123 HODENCAMP RD STE 103
THOUSAND OAKS CA
91360-5833
US

IV. Provider business mailing address

8752 DENVER ST
VENTURA CA
93004-2535
US

V. Phone/Fax

Practice location:
  • Phone: 805-746-3657
  • Fax:
Mailing address:
  • Phone: 805-746-3657
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: