Provider Demographics
NPI:1346701489
Name:HOCHRADEL, KERRY
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:HOCHRADEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11650 IBERIA PL
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-2406
Mailing Address - Country:US
Mailing Address - Phone:801-997-5840
Mailing Address - Fax:
Practice Address - Street 1:1625 SANTA VENETIA ST APT 4204
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91913-3096
Practice Address - Country:US
Practice Address - Phone:313-319-9691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker