MEDICARE: JESSICA HOGAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist

General Provider Information

NPI Number	:	1023973617
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA HOGAN

Provider Business Mailing Address
First Line	:	820 FLORIDA ST SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-4926
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3311 CANDELARIA RD NE STE E
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87107-1952
Country	:	US
Telephone Number	:	505-200-9962
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/17/2025
Last Update Date	:	12/17/2025

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Directions to “ JESSICA HOGAN ” Practice Location

Language	Start Address	Practice Location

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