Provider Demographics
NPI:1306485586
Name:HOKAMA, LORI (RPT)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:
Last Name:HOKAMA
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26431 MARSHFIELD LN UNIT 31
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:CA
Mailing Address - Zip Code:92630-6597
Mailing Address - Country:US
Mailing Address - Phone:949-735-9839
Mailing Address - Fax:
Practice Address - Street 1:466 FLAGSHIP RD
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92663-3635
Practice Address - Country:US
Practice Address - Phone:949-764-2116
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-05
Last Update Date:2020-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19377225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist