Provider Demographics
NPI:1487854105
Name:HAWKINS, ASA (RCP)
Entity type:Individual
Prefix:MR
First Name:ASA
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:RCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12407 TONIKAN RD
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92308-4109
Mailing Address - Country:US
Mailing Address - Phone:951-289-8125
Mailing Address - Fax:
Practice Address - Street 1:12407 TONIKAN RD
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92308-4109
Practice Address - Country:US
Practice Address - Phone:951-289-8125
Practice Address - Fax:951-848-0969
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-20
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00009856227800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227800000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Certified