MEDICARE: EMILY HAMOCON RDN

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
1	133VN1006X	Metabolic Nutrition Registered Dietitian
2	133VN1004X	Pediatric Nutrition Registered Dietitian
3	133VN1005X	Renal Nutrition Registered Dietitian
4	133VN1101X	Gerontological Nutrition Registered Dietitian
5	133V00000X	Registered Dietitian	86393079	CA
6	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian
7	133VN1301X	Oncology Nutrition Registered Dietitian
8	133VN1501X	Sports Dietetics Nutrition Registered Dietitian

General Provider Information

NPI Number	:	1780367383
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY HAMOCON RDN

Provider Business Mailing Address
First Line	:	427 MONTANA AVE APT 18
Second Line	:
City	:	SANTA MONICA
State	:	CA
Zip	:	90403-1324
Country	:	US
Telephone Number	:	818-804-8056
Fax Number	:

Provider Business Practice Location Address
First Line	:	1444 N POINSETTIA PL
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90046-4364
Country	:	US
Telephone Number	:	808-542-5131
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2023
Last Update Date	:	11/28/2024

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