Provider Demographics
NPI:1194055293
Name:HATCHER, PRINCESS ANNETTE (DPM)
Entity type:Individual
Prefix:DR
First Name:PRINCESS
Middle Name:ANNETTE
Last Name:HATCHER
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 BAILEY ST
Mailing Address - Street 2:APT 204
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-2460
Mailing Address - Country:US
Mailing Address - Phone:909-268-4577
Mailing Address - Fax:
Practice Address - Street 1:520 RICHEY ST
Practice Address - Street 2:#212
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92879-6186
Practice Address - Country:US
Practice Address - Phone:909-268-4577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2020-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4862213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery