Basic Information
| Provider Information | |||||||||
| NPI: | 1912915539 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOOVER | ||||||||
| FirstName: | JOSHUA | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 200 OCEANGATE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908024317 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5624996191 | ||||||||
| FaxNumber: | 8778602397 | ||||||||
| Practice Location | |||||||||
| Address1: | 7215 55TH ST | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958232601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9163991100 | ||||||||
| FaxNumber: | 8778602397 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/03/2006 | ||||||||
| LastUpdateDate: | 06/03/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/03/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | LCS18611 | CA | N | Behavioral Health & Social Service Providers | Social Worker | Clinical | 104100000X | LCS18611 | CA | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.