Provider Demographics
NPI:1538699871
Name:HOGUE, LENETTA G (ASW)
Entity Type:Individual
Prefix:
First Name:LENETTA
Middle Name:G
Last Name:HOGUE
Suffix:
Gender:F
Credentials:ASW
Other - Prefix:
Other - First Name:LENETTA
Other - Middle Name:ANN
Other - Last Name:GRANTHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 371134
Mailing Address - Street 2:
Mailing Address - City:MONTARA
Mailing Address - State:CA
Mailing Address - Zip Code:94037-1134
Mailing Address - Country:US
Mailing Address - Phone:281-731-2982
Mailing Address - Fax:
Practice Address - Street 1:2425 GEARY BLVD
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3358
Practice Address - Country:US
Practice Address - Phone:877-532-7951
Practice Address - Fax:844-574-3385
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW74647104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker