Individual
MR. JEFFERY BRENT HOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
1 SHIELDS AVE, ATHLETIC DEPT. UNIVERSITY OF CALIFORNIA, DAVIS, CA 95616-5270
(530) 752-0647
(530) 752-6681
Mailing address
1 SHIELDS AVE, ATHLETIC DEPT. UNIVERSITY OF CALIFORNIA, DAVIS, CA 95616-5270
(530) 752-0647
(530) 752-6681
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000080470
NATA BOC CERTIFICATION
—
Enumeration date
07/20/2006
Last updated
11/23/2011
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