Travis Hamblin, CMPSS
Individual provider Active NPI Peer Specialist · Campo, CA
NPI 1124904396 · NPPES record last updated Aug 13, 2025
Key facts
- NPI
- 1124904396
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- License
- MPSS-ICNZOV (CA)
- Practice address
- 1777 Buckman Springs Rd
Campo, CA 91906-2022 - Phone
- (619) 478-5696
- NPI assigned
- Aug 13, 2025
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MPSS-ICNZOV | CA | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| San Diego Freedom Ranch, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | MPSS-ICNZOV | CA | Yes |
Addresses
Primary practice location
1777 Buckman Springs Rd
Campo, CA 91906-2022
Mailing address
1777 Buckman Springs Rd
Campo, CA 91906-2022
Phone (619) 478-5696
Other providers in Campo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.