Healthcare Provider Details

I. General information

NPI: 1497206312
Provider Name (Legal Business Name): WENDY LYNN HOFFMAN L.M.F.T
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/14/2016
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15720 VENTURA BLVD STE 407
ENCINO CA
91436-4701
US

IV. Provider business mailing address

15720 VENTURA BLVD STE 407
ENCINO CA
91436-4701
US

V. Phone/Fax

Practice location:
  • Phone: 818-590-7154
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC29077
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: