Provider Demographics
NPI:1376529446
Name:HODAPP, KRISTIN (MS, PT)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:HODAPP
Suffix:
Gender:F
Credentials:MS, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5491 ESCARCHOSA LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92124-1835
Mailing Address - Country:US
Mailing Address - Phone:858-505-1390
Mailing Address - Fax:
Practice Address - Street 1:USS RONALD REAGAN CVN76
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96616-2876
Practice Address - Country:US
Practice Address - Phone:619-545-0246
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-20
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA028792251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic