Individual provider Active NPI

Vicki Renee Hammond, A.T.C., P.T.A

  • Physical Therapy Assistant
  • Anaheim, CA
National Provider Identifier
1538313606
Registry record updated Nov 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
AT-6149 Issued in CA
Practice address
300 S Harbor Blvd
Suite 710
Anaheim, CA 92805-3733
Phone
(800) 561-5207
NPI assigned
Nov 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X AT-6149 CA Primary
Athletic Trainer 2255A2300X 029602579 CA

Addresses

Primary practice location

300 S Harbor Blvd
Suite 710
Anaheim, CA 92805-3733

Mailing address

6603 Michelson St
Lakewood, CA 90713-1755
Phone (562) 925-8685

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

LicenseStateTypeSpecialty
AT-6149CAMDPhysical Therapy Assistant
029602579CAMDAthletic Trainer

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1226707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1226707200000",
    "number": "1538313606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6603 MICHELSON ST",
            "city": "LAKEWOOD",
            "state": "CA",
            "postal_code": "907131755",
            "telephone_number": "562-925-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S HARBOR BLVD",
            "address_2": "SUITE 710",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928053733",
            "telephone_number": "800-561-5207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMMOND",
        "first_name": "VICKI",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "A.T.C., P.T.A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-15",
        "last_updated": "2008-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "AT-6149",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "CA",
            "license": "029602579",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Anaheim, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.