Provider Demographics
NPI:1952966988
Name:HOPKINS, MALLORIE B (DPT)
Entity type:Individual
Prefix:
First Name:MALLORIE
Middle Name:B
Last Name:HOPKINS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2651 IRVINE AVE STE 138
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92627-4647
Mailing Address - Country:US
Mailing Address - Phone:949-612-7695
Mailing Address - Fax:
Practice Address - Street 1:2651 IRVINE AVE STE 138
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92627-4647
Practice Address - Country:US
Practice Address - Phone:949-612-7695
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-06
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL0016259225100000X
NJ40QA01853000225100000X
CAPT300877225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist