Healthcare Provider Details

I. General information

NPI: 1770496200
Provider Name (Legal Business Name): JEREMY LEE HOFFMAN NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20141 PESCARA LN
FRIANT CA
93626-7931
US

IV. Provider business mailing address

20141 PESCARA LN
FRIANT CA
93626-7931
US

V. Phone/Fax

Practice location:
  • Phone: 412-592-3743
  • Fax:
Mailing address:
  • Phone: 412-592-3743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number95035554
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: