Provider Demographics
NPI:1811763147
Name:HOCANSON, JAIME KATHLEEN (LCSW)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:KATHLEEN
Last Name:HOCANSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4750 DATE AVE
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-9214
Mailing Address - Country:US
Mailing Address - Phone:619-669-5700
Mailing Address - Fax:
Practice Address - Street 1:4750 DATE AVE
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-9214
Practice Address - Country:US
Practice Address - Phone:619-668-5700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1051711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical