Healthcare Provider Details

I. General information

NPI: 1225647803
Provider Name (Legal Business Name): DAVID BRAM HOFFMAN MSW/ASW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2020
Last Update Date: 07/29/2020
Certification Date: 07/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 E VIRGINIA ST STE 100
SAN JOSE CA
95112-5865
US

IV. Provider business mailing address

160 E VIRGINIA ST STE 280
SAN JOSE CA
95112-5817
US

V. Phone/Fax

Practice location:
  • Phone: 408-938-2113
  • Fax: 408-579-6143
Mailing address:
  • Phone: 408-287-6200
  • Fax: 408-998-1535

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number94354
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: