Healthcare Provider Details

I. General information

NPI: 1932077898
Provider Name (Legal Business Name): KORISSA HOBBS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2025
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 CALIFORNIA ST STE 1400
SAN FRANCISCO CA
94104-2116
US

IV. Provider business mailing address

2601 WHITNEY ST
HOUSTON TX
77006-3023
US

V. Phone/Fax

Practice location:
  • Phone: 212-589-2700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86292582
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: