Healthcare Provider Details

I. General information

NPI: 1316774466
Provider Name (Legal Business Name): ROSEMARY HOFFLUND-HANSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2024
Last Update Date: 09/13/2024
Certification Date: 09/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10323 SANTA MONICA BLVD STE 102
LOS ANGELES CA
90025-5056
US

IV. Provider business mailing address

10323 SANTA MONICA BLVD STE 102
LOS ANGELES CA
90025-5056
US

V. Phone/Fax

Practice location:
  • Phone: 424-421-2273
  • Fax:
Mailing address:
  • Phone: 424-421-2273
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: