Healthcare Provider Details

I. General information

NPI: 1508163056
Provider Name (Legal Business Name): ANTHONY STEVEN HOBBS M.S. CCC-SLP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2011
Last Update Date: 08/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4001 LONE TREE WAY
ANTIOCH CA
94509
US

IV. Provider business mailing address

4560 SE INTERNATIONAL WAY STE. 100
MILWAUKIE OR
97222
US

V. Phone/Fax

Practice location:
  • Phone: 925-754-0470
  • Fax: 925-754-2775
Mailing address:
  • Phone: 971-206-5200
  • Fax: 971-206-5203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License NumberSP 9751
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number19365
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: