Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ebony Hysaw

Individual provider Contractor · NPI 1841145695

Ebony Hysaw is a Contractor in Downey, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2026

Practice location Address checks out

9649 Lakewood Blvd
Downey, CA 90240-3308
Phone: (562) 417-7449
Fax: (562) 280-2813
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Contractor (primary) Taxonomy 171W00000X · Licence L9748 (CA)

Record details

NPI number1841145695
Entity typeIndividual (Type 1)
GenderNot disclosed
Sole proprietorYes
NPI enumeratedFebruary 26, 2026
Last updated in NPPESFebruary 26, 2026
Certification dateFebruary 26, 2026
Mailing addressPo Box 4054, Lakewood, CA 90711-4054

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