Provider Demographics
NPI:1316713118
Name:HOEKSTRA, FARRAH J (LCSW)
Entity type:Individual
Prefix:
First Name:FARRAH
Middle Name:J
Last Name:HOEKSTRA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3195 HUMPHREY RD
Mailing Address - Street 2:
Mailing Address - City:LOOMIS
Mailing Address - State:CA
Mailing Address - Zip Code:95650-9095
Mailing Address - Country:US
Mailing Address - Phone:559-589-4242
Mailing Address - Fax:
Practice Address - Street 1:3195 HUMPHREY RD
Practice Address - Street 2:
Practice Address - City:LOOMIS
Practice Address - State:CA
Practice Address - Zip Code:95650-9095
Practice Address - Country:US
Practice Address - Phone:559-589-4242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1172881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical