Provider Demographics
NPI:1164231593
Name:HAMPTON, DESTINY DENOTRA JANAE
Entity type:Individual
Prefix:
First Name:DESTINY
Middle Name:DENOTRA JANAE
Last Name:HAMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3455 KEARNY VILLA RD APT 240
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-1978
Mailing Address - Country:US
Mailing Address - Phone:619-379-5233
Mailing Address - Fax:
Practice Address - Street 1:3455 KEARNY VILLA RD APT 240
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1978
Practice Address - Country:US
Practice Address - Phone:619-379-5233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula