Healthcare Provider Details

I. General information

NPI: 1689826927
Provider Name (Legal Business Name): ANTJE HOFMEISTER L.M.F.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/17/2008
Last Update Date: 04/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2504 CLAY ST
SAN FRANCISCO CA
94115-1811
US

IV. Provider business mailing address

2504 CLAY ST
SAN FRANCISCO CA
94115-1811
US

V. Phone/Fax

Practice location:
  • Phone: 415-265-1109
  • Fax: 888-965-5619
Mailing address:
  • Phone: 415-265-1109
  • Fax: 888-965-5619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC43710
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: