Individual
NICOLE MARIE HAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
23357 MOBILE ST, WEST HILLS, CA 91307-3322
(805) 433-2119
(805) 433-2119
Mailing address
23357 MOBILE ST, WEST HILLS, CA 91307-3322
(805) 433-2119
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
CA
Other
Enumeration date
10/19/2017
Last updated
10/19/2017
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