Healthcare Provider Details

I. General information

NPI: 1912110883
Provider Name (Legal Business Name): GAYLE L HOFFMAN LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

795 FLETCHER LN
HAYWARD CA
94544-1008
US

IV. Provider business mailing address

1198 JEFFERSON ST APT #303
SAN LEANDRO CA
94577-4542
US

V. Phone/Fax

Practice location:
  • Phone: 510-247-8300
  • Fax: 510-247-8295
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License NumberVN 127080
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: