Healthcare Provider Details

I. General information

NPI: 1093693160
Provider Name (Legal Business Name): ALYSSA MOANA HOFF FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 1ST AVE
SAN DIEGO CA
92101-2685
US

IV. Provider business mailing address

2552 2ND AVE
SAN DIEGO CA
92103-6537
US

V. Phone/Fax

Practice location:
  • Phone: 619-233-4044
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95036145
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: