Provider Demographics
NPI:1043562457
Name:HOSKING, GINA (PA)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:HOSKING
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 BALLINDINE DR
Mailing Address - Street 2:
Mailing Address - City:VACAVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95688-9201
Mailing Address - Country:US
Mailing Address - Phone:707-446-4157
Mailing Address - Fax:
Practice Address - Street 1:600 NUT TREE RD
Practice Address - Street 2:SUITE 320
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4669
Practice Address - Country:US
Practice Address - Phone:707-449-6373
Practice Address - Fax:707-449-0839
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-09
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA22355363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical