Healthcare Provider Details

I. General information

NPI: 1477386241
Provider Name (Legal Business Name): ANDREW PAUL HOFFMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ANDY HOFFMAN

II. Dates (important events)

Enumeration Date: 08/26/2024
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10717 CAMINO RUIZ STE 207
SAN DIEGO CA
92126-2364
US

IV. Provider business mailing address

10717 CAMINO RUIZ STE 207
SAN DIEGO CA
92126-2364
US

V. Phone/Fax

Practice location:
  • Phone: 858-695-2211
  • Fax:
Mailing address:
  • Phone: 858-695-2211
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: