Provider Demographics
NPI:1992766422
Name:HOPFE, DUSTIN IKAIKA (ATC)
Entity type:Individual
Prefix:
First Name:DUSTIN
Middle Name:IKAIKA
Last Name:HOPFE
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10195 ROBILEE CT
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-3060
Mailing Address - Country:US
Mailing Address - Phone:831-801-3004
Mailing Address - Fax:
Practice Address - Street 1:10195 ROBILEE CT
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-3060
Practice Address - Country:US
Practice Address - Phone:831-801-3004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-02
Last Update Date:2023-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV05062632255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer