Healthcare Provider Details

I. General information

NPI: 1396070132
Provider Name (Legal Business Name): DEBI HOFFMAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/13/2009
Last Update Date: 01/19/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1580 CREEKSIDE DR SUITE 240
FOLSOM CA
95630-3886
US

IV. Provider business mailing address

1580 CREEKSIDE DR SUITE 240
FOLSOM CA
95630-3886
US

V. Phone/Fax

Practice location:
  • Phone: 916-770-5579
  • Fax:
Mailing address:
  • Phone: 916-770-5579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY23061
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: