Provider Demographics
NPI:1164037792
Name:HOAG, JASON HENRY
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:HENRY
Last Name:HOAG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 COMPASS CIR
Mailing Address - Street 2:
Mailing Address - City:EAST FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02536-4705
Mailing Address - Country:US
Mailing Address - Phone:415-828-9201
Mailing Address - Fax:
Practice Address - Street 1:100 INDEPENDENCE DR UNIT 8
Practice Address - Street 2:
Practice Address - City:HYANNIS
Practice Address - State:MA
Practice Address - Zip Code:02601-1898
Practice Address - Country:US
Practice Address - Phone:508-778-1839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling