Provider Demographics
NPI:1861039356
Name:HOGGARD, STEVIE L (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:STEVIE
Middle Name:L
Last Name:HOGGARD
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:361 E 18TH ST APT 4
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-3176
Mailing Address - Country:US
Mailing Address - Phone:122-592-1877
Mailing Address - Fax:
Practice Address - Street 1:361 E 18TH ST APT 4
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-3176
Practice Address - Country:US
Practice Address - Phone:225-921-8774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27909235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist