Provider Demographics
NPI:1790909927
Name:HOYLE, JERRY D (JERRY HOYLE, PH D)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:D
Last Name:HOYLE
Suffix:
Gender:M
Credentials:JERRY HOYLE, PH D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-6633
Mailing Address - Country:US
Mailing Address - Phone:909-793-5807
Mailing Address - Fax:909-307-5630
Practice Address - Street 1:420 BROOKSIDE AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-4610
Practice Address - Country:US
Practice Address - Phone:909-732-0005
Practice Address - Fax:909-307-5630
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY7733103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical