Provider Demographics
NPI:1487716130
Name:HOGLIN, SHERRIE L (AUD)
Entity type:Individual
Prefix:DR
First Name:SHERRIE
Middle Name:L
Last Name:HOGLIN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11836 HEMLOCK ST
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91732-1413
Mailing Address - Country:US
Mailing Address - Phone:909-392-0302
Mailing Address - Fax:909-392-0216
Practice Address - Street 1:175 W LA VERNE AVE
Practice Address - Street 2:SUITE B
Practice Address - City:POMONA
Practice Address - State:CA
Practice Address - Zip Code:91767-2347
Practice Address - Country:US
Practice Address - Phone:909-392-0302
Practice Address - Fax:909-392-0216
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAU740231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAU0007400Medicaid
CAAUD740Medicare ID - Type Unspecified