Healthcare Provider Details

I. General information

NPI: 1053790261
Provider Name (Legal Business Name): COLLEEN HOEHN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2015
Last Update Date: 05/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

597 CENTER AVE SUITE 200
MARTINEZ CA
94553-4640
US

IV. Provider business mailing address

1029 GRAYSON ST
BERKELEY CA
94710-2642
US

V. Phone/Fax

Practice location:
  • Phone: 925-313-6740
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number638778
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: