Provider Demographics
NPI:1184182537
Name:HOCUTT, JAN THERESE (SLP)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:THERESE
Last Name:HOCUTT
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:JAN
Other - Middle Name:THERESE
Other - Last Name:NORMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:69472 SERENITY RD
Mailing Address - Street 2:
Mailing Address - City:CATHEDRAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:92234-7921
Mailing Address - Country:US
Mailing Address - Phone:760-831-5228
Mailing Address - Fax:866-225-9947
Practice Address - Street 1:69472 SERENITY RD
Practice Address - Street 2:
Practice Address - City:CATHEDRAL CITY
Practice Address - State:CA
Practice Address - Zip Code:92234-7921
Practice Address - Country:US
Practice Address - Phone:760-831-5228
Practice Address - Fax:866-225-9947
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28449225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist