Individual
NICOLE LAUREN HOCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDA
Contact information
Practice address
15710 LASSELLE ST APT 6P, MORENO VALLEY, CA 92551-1681
(909) 800-7828
Mailing address
15710 LASSELLE ST APT 6P, MORENO VALLEY, CA 92551-1681
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
70687
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70687
—
CA
Enumeration date
01/16/2020
Last updated
01/16/2020
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