Provider Demographics
NPI:1053746685
Name:HOKANSON, ASHLEY SUZANNE (BCBA)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SUZANNE
Last Name:HOKANSON
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3245 UNIVERSITY AVE
Mailing Address - Street 2:1-334
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92104-2009
Mailing Address - Country:US
Mailing Address - Phone:508-873-4696
Mailing Address - Fax:619-795-0814
Practice Address - Street 1:4455 MURPHY CANYON RD
Practice Address - Street 2:100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-4379
Practice Address - Country:US
Practice Address - Phone:619-281-6067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-13
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1-13-13901103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst