Healthcare Provider Details

I. General information

NPI: 1205654019
Provider Name (Legal Business Name): KURT C HOHENSEE ACSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: K.C. HOHENSEE

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 11/12/2025
Certification Date: 11/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 E REDLANDS BLVD STE 215
REDLANDS CA
92373-4724
US

IV. Provider business mailing address

101 E REDLANDS BLVD STE 215
REDLANDS CA
92373-4724
US

V. Phone/Fax

Practice location:
  • Phone: 909-793-1078
  • Fax: 909-335-7330
Mailing address:
  • Phone: 909-793-1078
  • Fax: 909-335-7330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number133533
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: