Healthcare Provider Details
I. General information
NPI: 1720097009
Provider Name (Legal Business Name): DAVID A. 'TONY' HOFFMAN PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 08/05/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
303 POTRERO ST STE 55
SANTA CRUZ CA
95060-2760
US
IV. Provider business mailing address
303 POTRERO ST STE 55
SANTA CRUZ CA
95060-2760
US
V. Phone/Fax
- Phone: 831-423-4073
- Fax: 831-423-6106
- Phone: 831-423-4073
- Fax: 831-423-6106
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | PSY11455 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | PSY11455 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: