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NPI Code Detail

MEDICARE: MRS. JESSIE BURR HOCKETT PA-C

MEDICARE: MRS. JESSIE BURR HOCKETT PA-C
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
1363A00000XPhysician AssistantPA.0003335CO
2363A00000XPhysician Assistant0010-14950NC
3363A00000XPhysician AssistantPA100991MA
4363A00000XPhysician Assistant12651GA
5363A00000XPhysician AssistantPA60595611WA
6363A00000XPhysician AssistantPA13229TX
7363A00000XPhysician Assistant10646AZ

General Provider Information

NPI Number : 1396026225
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JESSIE BURR HOCKETT PA-C
Provider Business Mailing Address
First Line : 1 EMBARCADERO CTR FL 19
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94111-3628
Country : US
Telephone Number :
Fax Number : 415-252-7176
Provider Business Practice Location Address
First Line : 2201 E CAMELBACK RD STE 101A
Second Line :
City : PHOENIX
State : AZ
Zip : 85016-3495
Country : US
Telephone Number : 888-663-6331
Fax Number : 415-252-7176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2011
Last Update Date : 07/15/2025

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