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NPI Code Detail

MEDICARE: DR. LORIENE HATSUMI HONDA PH.D.

MEDICARE: DR. LORIENE HATSUMI HONDA PH.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC2200XClinical Child & Adolescent PsychologistPSY19126CA

General Provider Information

NPI Number : 1184776296
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. LORIENE HATSUMI HONDA PH.D.
Provider Business Mailing Address
First Line : 801 EMPIRE ST
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-5702
Country : US
Telephone Number : 707-425-5744
Fax Number : 707-425-5162
Provider Business Practice Location Address
First Line : 801 EMPIRE ST
Second Line :
City : FAIRFIELD
State : CA
Zip : 94533-5702
Country : US
Telephone Number : 707-425-5744
Fax Number : 707-425-5162
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2007
Last Update Date : 07/08/2007

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