Healthcare Provider Details
I. General information
NPI: 1770887754
Provider Name (Legal Business Name): MARCELLA J HOJNACKI MSW TRAINEE
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/05/2011
Last Update Date: 01/05/2011
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
516 N KAWEAH AVE
EXETER CA
93221-1200
US
IV. Provider business mailing address
516 N KAWEAH AVE
EXETER CA
93221-1200
US
V. Phone/Fax
- Phone: 559-594-4969
- Fax: 559-592-9250
- Phone: 559-594-4969
- Fax: 559-592-9250
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: