1679717755 NPI number — MRS. HERMEISHA RENEE HOPSON LCSW

Table of content: MRS. HERMEISHA RENEE HOPSON LCSW (NPI 1679717755)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679717755 NPI number — MRS. HERMEISHA RENEE HOPSON LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOPSON
Provider First Name:
HERMEISHA
Provider Middle Name:
RENEE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GREEN
Provider Other First Name:
HERMEISHA
Provider Other Middle Name:
RENEE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1679717755
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11301 WILSHIRE BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOS ANGELES
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90073-1003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-478-3711
Provider Business Mailing Address Fax Number:
310-268-4050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11301 WILSHIRE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOS ANGELES
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90073-1003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-478-3711
Provider Business Practice Location Address Fax Number:
310-268-4050
Provider Enumeration Date:
04/21/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  C008500 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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