Active NPI
Raven Monique Hawthorne
- Peer Specialist
- Hanford, CA
National Provider Identifier
1174167241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Peer Specialist
- License
- MPSS-IQROF
- Practice address
- 530 Kings County Dr Ste 104106
Hanford, CA 93230-3579 - Phone
- (559) 754-3128
- NPI assigned
- Nov 1, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | MPSS-IQROF | CA | Primary |
Addresses
Primary practice location
530 Kings County Dr Ste 104106
Hanford, CA 93230-3579
Mailing address
530 Kings County Dr Ste 104106
Hanford, CA 93230-3579
Phone (559) 754-3128
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MPSS-IQROF | CA | MD | Peer Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709683200000",
"number": "1174167241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "530 KINGS COUNTY DR STE 104106",
"city": "HANFORD",
"state": "CA",
"postal_code": "932303579",
"telephone_number": "559-754-3128"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 KINGS COUNTY DR STE 104106",
"city": "HANFORD",
"state": "CA",
"postal_code": "932303579",
"telephone_number": "559-754-3128"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAWTHORNE",
"first_name": "RAVEN",
"middle_name": "MONIQUE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-01",
"last_updated": "2024-03-06",
"certification_date": "2024-03-06",
"status": "A"
},
"taxonomies": [
{
"code": "175T00000X",
"taxonomy_group": "",
"desc": "Peer Specialist",
"state": "CA",
"license": "MPSS-IQROF",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.