Individual
KHADIJA H HAMISI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11801 PIERCE ST STE 200, RIVERSIDE, CA 92505-4400
(909) 429-3244
(909) 981-0821
Mailing address
1747 STEINMAN ST, RIVERSIDE, CA 92507-7809
(951) 906-4786
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
698511
CA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
20560
CA
Other
Enumeration date
02/12/2010
Last updated
05/22/2023
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