Healthcare Provider Details

I. General information

NPI: 1295570588
Provider Name (Legal Business Name): SYDNEY HODSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2024
Last Update Date: 06/27/2024
Certification Date: 06/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4128 S DEMAREE ST STE B
VISALIA CA
93277-9514
US

IV. Provider business mailing address

4128 S DEMAREE ST STE B
VISALIA CA
93277-9514
US

V. Phone/Fax

Practice location:
  • Phone: 559-741-7358
  • Fax: 559-390-4460
Mailing address:
  • Phone: 559-741-7358
  • Fax: 559-390-4460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: