Provider Demographics
NPI:1487187886
Name:HOPCKE, ROBERT HENRY (MFT)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:HENRY
Last Name:HOPCKE
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 DOMINGO AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2400
Mailing Address - Country:US
Mailing Address - Phone:510-548-7668
Mailing Address - Fax:
Practice Address - Street 1:2920 DOMINGO AVE STE 203
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94705-2400
Practice Address - Country:US
Practice Address - Phone:510-548-7668
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-04
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC22658106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist