| Jeffrey Thomas Hodgson, MS CCC-SLP | |
|
519 S Shoal Creek St, Banning, CA 92220-5210 | |
| (530) 966-3675 | |
| Not Available |
| Full Name | Jeffrey Thomas Hodgson |
|---|---|
| Gender | Male |
| Speciality | Speech-language Pathologist |
| Location | 519 S Shoal Creek St, Banning, California |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073724399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 235Z00000X | Speech-language Pathologist | 10700 (California) | Primary |
| Provider Name | Permanente Medical Group Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Jeffrey Thomas Hodgson, MS CCC-SLP 519 S Shoal Creek St, Banning, CA 92220-5210 Ph: (530) 966-3675 | Jeffrey Thomas Hodgson, MS CCC-SLP 519 S Shoal Creek St, Banning, CA 92220-5210 Ph: (530) 966-3675 |
Amy Yasul, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 161 W Williams St, Banning, CA 92220 Phone: 951-563-8522 | |
Huma Qureshi, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 161 W Williams St, Banning, CA 92220 Phone: 951-922-0200 | |
Andrea Grout, Speech-Language Pathologist Medicare: Not Enrolled in Medicare Practice Location: 161 W Williams St, Banning, CA 92220 Phone: 951-892-9048 |