Provider Demographics
NPI:1841543121
Name:HOOPER, JOANIE MARIE (OTR/L)
Entity type:Individual
Prefix:
First Name:JOANIE
Middle Name:MARIE
Last Name:HOOPER
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 KELMORE ST
Mailing Address - Street 2:
Mailing Address - City:MOSS BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:94038-9707
Mailing Address - Country:US
Mailing Address - Phone:650-773-1934
Mailing Address - Fax:
Practice Address - Street 1:3401 MISSION ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-5419
Practice Address - Country:US
Practice Address - Phone:650-773-1934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOT 1086171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor