Healthcare Provider Details

I. General information

NPI: 1528921046
Provider Name (Legal Business Name): FRED HOFF
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 GUERNEVILLE RD
SANTA ROSA CA
95401-4030
US

IV. Provider business mailing address

3250 GUERNEVILLE RD
SANTA ROSA CA
95401-4030
US

V. Phone/Fax

Practice location:
  • Phone: 707-579-4066
  • Fax:
Mailing address:
  • Phone: 707-579-4066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: