Provider Demographics
NPI:1558576975
Name:HOOVEN, EUGENIA ANN
Entity Type:Individual
Prefix:
First Name:EUGENIA
Middle Name:ANN
Last Name:HOOVEN
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:PO BOX 462
Mailing Address - Street 2:11135 MERRELL RD.
Mailing Address - City:GROVELAND
Mailing Address - State:CA
Mailing Address - Zip Code:95321-0462
Mailing Address - Country:US
Mailing Address - Phone:209-962-6422
Mailing Address - Fax:
Practice Address - Street 1:18638 MAIN ST
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:CA
Practice Address - Zip Code:95321-9432
Practice Address - Country:US
Practice Address - Phone:209-962-5211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13502247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other