Provider Demographics
NPI:1659794527
Name:HOPPES, KERRIE JANE (MFT)
Entity Type:Individual
Prefix:
First Name:KERRIE
Middle Name:JANE
Last Name:HOPPES
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10232 ORIOLE LN
Mailing Address - Street 2:
Mailing Address - City:PALO CEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:96073-9717
Mailing Address - Country:US
Mailing Address - Phone:530-515-8199
Mailing Address - Fax:
Practice Address - Street 1:10232 ORIOLE LN
Practice Address - Street 2:
Practice Address - City:PALO CEDRO
Practice Address - State:CA
Practice Address - Zip Code:96073-9717
Practice Address - Country:US
Practice Address - Phone:530-515-8199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43386106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist