Healthcare Provider Details

I. General information

NPI: 1811693294
Provider Name (Legal Business Name): MRS. VICTORIA ANNA HOGAN-PERKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44359 PALM ST
INDIO CA
92201-3116
US

IV. Provider business mailing address

738 NE DAVIS ST
PORTLAND OR
97232-2931
US

V. Phone/Fax

Practice location:
  • Phone: 760-342-6616
  • Fax:
Mailing address:
  • Phone: 503-542-4603
  • Fax: 503-233-6093

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: