Provider Demographics
NPI:1396094322
Name:KIM LORI HOPPIN
Entity type:Organization
Organization Name:KIM LORI HOPPIN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIM
Authorized Official - Middle Name:L
Authorized Official - Last Name:HOPPIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:415-381-1567
Mailing Address - Street 1:319 MILLER AVE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MILL VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94941-5904
Mailing Address - Country:US
Mailing Address - Phone:415-381-1567
Mailing Address - Fax:415-381-1568
Practice Address - Street 1:319 MILLER AVE
Practice Address - Street 2:SUITE 3
Practice Address - City:MILL VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94941-5904
Practice Address - Country:US
Practice Address - Phone:415-381-1567
Practice Address - Fax:415-381-1568
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid FitterGroup - Single Specialty