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NPI Code Detail

MEDICARE: MRS. NELLNI SUPRIYA HOGAN LMFT

MEDICARE:  MRS. NELLNI SUPRIYA HOGAN  LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist84295CA

General Provider Information

NPI Number : 1588851653
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NELLNI SUPRIYA HOGAN LMFT
Provider Business Mailing Address
First Line : 2828 FORD ST
Second Line :
City : OAKLAND
State : CA
Zip : 94601-2114
Country : US
Telephone Number : 510-317-1444
Fax Number :
Provider Business Practice Location Address
First Line : 2828 FORD ST
Second Line :
City : OAKLAND
State : CA
Zip : 94601-2114
Country : US
Telephone Number : 510-317-1444
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2007
Last Update Date : 04/10/2023

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Directions to “ MRS. NELLNI SUPRIYA HOGAN LMFT” Practice Location

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