Provider Demographics
NPI:1851328462
Name:HOYT, JENNIFER SUE (PA)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SUE
Last Name:HOYT
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 50706
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93150-0706
Mailing Address - Country:US
Mailing Address - Phone:805-563-0024
Mailing Address - Fax:805-563-1454
Practice Address - Street 1:221 W PUEBLO ST
Practice Address - Street 2:SUITE B
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-6814
Practice Address - Country:US
Practice Address - Phone:805-563-0024
Practice Address - Fax:805-563-1454
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA13063363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA449828851OtherTAX ID
CA449828851OtherTAX ID
CAR93011Medicare UPIN