Hogan, Jeffery Brent

Hogan, Jeffery Brent is an individual health care provider with primary practice located at 1 Shields Ave Athletic Dept. University Of California, Davis CA 95616-5270. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer, which is considered as his primary health care specialty. Hogan, Jeffery Brent can be contacted via phone (530) 752-0647.

Contact Information

Primary practice address
1 Shields Ave Athletic Dept. University Of California Davis CA 95616-5270
Phone: (530) 752-0647
Fax: (530) 752-6681
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Athletic Trainer 2255A2300X

Profile Details

NPI number 1144240326
LBN Legal business name Hogan, Jeffery Brent
Credentials Athletic Trainer, Certified (ATC)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Nov 23rd, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144240326 NPPES
Other 000080470 NATA BOC CERTIFICATION

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