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General NPI Number Information
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NPI Number | 1497438386
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Entity Type | Individual
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Provider Name | MAAME-MENSIMA HORNE ND
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Gender | Female
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Dates
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Enumeration Date | 08/08/2023
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 10474 SANTA MONICA BLVD STE 305
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City | LOS ANGELES
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State | CA
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Zip | 90025-6931
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Country | US
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Telephone | 310-596-5480
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Fax |
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Provider Business Mailing Address
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Address Line | 1535 HARVARD ST APT D
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City | SANTA MONICA
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State | CA
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Zip | 90404-5561
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Country | US
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Telephone | 480-696-9586
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number | ND1527
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 227.022863
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License Number State | IL
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