Healthcare Provider Details

I. General information

NPI: 1912105941
Provider Name (Legal Business Name): REBECCA MARION HOFMAN B.A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/11/2007
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E GILBERT ST
SAN BERNARDINO CA
92415-0911
US

IV. Provider business mailing address

17195 VIA LOS CABALLEROS
RIVERSIDE CA
92504-6138
US

V. Phone/Fax

Practice location:
  • Phone: 909-387-7406
  • Fax:
Mailing address:
  • Phone: 951-536-9890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: