Healthcare Provider Details

I. General information

NPI: 1578083804
Provider Name (Legal Business Name): MICHAEL ANTHONY HOSKINS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2017
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1904 RICHLAND AVE # BUILDH
CERES CA
95307-4562
US

IV. Provider business mailing address

1904 RICHLAND AVE BLDG H
CERES CA
95307-4562
US

V. Phone/Fax

Practice location:
  • Phone: 209-499-9481
  • Fax:
Mailing address:
  • Phone: 209-499-9481
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: