Provider Demographics
NPI:1902216633
Name:HOPPER, H SAMUEL III (PHD)
Entity Type:Individual
Prefix:DR
First Name:H
Middle Name:SAMUEL
Last Name:HOPPER
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:MR
Other - First Name:HARRY
Other - Middle Name:SAMUEL
Other - Last Name:HOPPER
Other - Suffix:III
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2708 WILSHIRE BLVD #214
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-4706
Mailing Address - Country:US
Mailing Address - Phone:310-413-4828
Mailing Address - Fax:
Practice Address - Street 1:3201 WILSHIRE BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-2344
Practice Address - Country:US
Practice Address - Phone:310-413-4828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-02
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY-32433103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist