Healthcare Provider Details

I. General information

NPI: 1265224521
Provider Name (Legal Business Name): SELENA MARIE HOFMANS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/21/2025
Last Update Date: 05/21/2025
Certification Date: 05/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 E FOOTHILL BLVD STE 100
ARCADIA CA
91006-2314
US

IV. Provider business mailing address

50 E FOOTHILL BLVD STE 100
ARCADIA CA
91006-2314
US

V. Phone/Fax

Practice location:
  • Phone: 714-681-6735
  • Fax: 714-681-6735
Mailing address:
  • Phone: 714-681-6735
  • Fax: 714-681-6735

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number39414
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: