Individual
KENNETH GEORGE HOGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6500 MORRO RD STE D, ATASCADERO, CA 93422-4142
(805) 461-5212
Mailing address
6500 MORRO RD STE D, ATASCADERO, CA 93422-4142
(805) 461-5212
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
30402
CA
Other
Enumeration date
09/19/2019
Last updated
12/04/2019
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