Provider Demographics
NPI:1700038718
Name:HOYT, CHARLES KEN VII (BA)
Entity type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:KEN
Last Name:HOYT
Suffix:VII
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2902 BLACKSAND CREEK WAY
Mailing Address - Street 2:
Mailing Address - City:RIVERBANK
Mailing Address - State:CA
Mailing Address - Zip Code:95367-9451
Mailing Address - Country:US
Mailing Address - Phone:209-657-8642
Mailing Address - Fax:
Practice Address - Street 1:1620 CUMMINS DR # B2
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95358-6400
Practice Address - Country:US
Practice Address - Phone:209-576-1750
Practice Address - Fax:209-576-1768
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
CA372600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
No171M00000XOther Service ProvidersCase Manager/Care Coordinator