Provider Demographics
NPI:1922244177
Name:HOGAN, EILEEN ELIZABETH (MS)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:ELIZABETH
Last Name:HOGAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1951 ABBOTT ST
Mailing Address - Street 2:A
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-4826
Mailing Address - Country:US
Mailing Address - Phone:619-224-7730
Mailing Address - Fax:
Practice Address - Street 1:1951 ABBOTT ST
Practice Address - Street 2:A
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92107-4826
Practice Address - Country:US
Practice Address - Phone:619-224-7730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health