Healthcare Provider Details

I. General information

NPI: 1295528487
Provider Name (Legal Business Name): DANAE HOBER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 05/28/2025
Certification Date: 05/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11959 NICHOLSON DR APT 16204
BATON ROUGE LA
70810-7612
US

IV. Provider business mailing address

11959 NICHOLSON DR APT 16204
BATON ROUGE LA
70810-7612
US

V. Phone/Fax

Practice location:
  • Phone: 619-709-1902
  • Fax:
Mailing address:
  • Phone: 619-709-1902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberY5281295
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: