Provider Demographics
NPI:1790404754
Name:HOTCHKISS, BRIAN KEITH (MMT, MT-BC)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:KEITH
Last Name:HOTCHKISS
Suffix:
Gender:M
Credentials:MMT, MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:855 N LEMON ST UNIT 2
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-6658
Mailing Address - Country:US
Mailing Address - Phone:949-433-3967
Mailing Address - Fax:
Practice Address - Street 1:855 N LEMON ST UNIT 2
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92867-6658
Practice Address - Country:US
Practice Address - Phone:949-433-3967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16627225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist