Healthcare Provider Details

I. General information

NPI: 1588705503
Provider Name (Legal Business Name): MARCIA HOFFMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5762 BOLSA AVE SUITE 107
HUNTINGTON BEACH CA
92649-1172
US

IV. Provider business mailing address

7 HONEYSUCKLE
IRVINE CA
92614-7084
US

V. Phone/Fax

Practice location:
  • Phone: 714-387-3242
  • Fax:
Mailing address:
  • Phone: 714-387-3242
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLCS19617
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: