Provider Demographics
NPI:1023343860
Name:HOGGARD, THERESA
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:
Last Name:HOGGARD
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:TERI
Other - Middle Name:
Other - Last Name:HOGGARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1900 E LA PALMA AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-1647
Mailing Address - Country:US
Mailing Address - Phone:714-399-3480
Mailing Address - Fax:
Practice Address - Street 1:1900 E LA PALMA AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-1647
Practice Address - Country:US
Practice Address - Phone:714-399-3480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-13
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No172V00000XOther Service ProvidersCommunity Health Worker