Healthcare Provider Details

I. General information

NPI: 1811058142
Provider Name (Legal Business Name): MERYL HOFFMAN-PAGAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 01/03/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

275 BECK AVE MS 5-230
FAIRFIELD CA
94533-6804
US

IV. Provider business mailing address

242 PEBBLECREEK CT
MARTINEZ CA
94553-6806
US

V. Phone/Fax

Practice location:
  • Phone: 707-784-8492
  • Fax:
Mailing address:
  • Phone: 925-229-2262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW 23422
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: