Healthcare Provider Details

I. General information

NPI: 1275722407
Provider Name (Legal Business Name): ANNE HOFMANN RN, PHN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2007
Last Update Date: 10/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 CENTERPOINTE PKWY SANTA MARIA PUBLIC HEALTH CLINIC
SANTA MARIA CA
93455-1334
US

IV. Provider business mailing address

300 N SAN ANTONIO RD
SANTA BARBARA CA
93110-1316
US

V. Phone/Fax

Practice location:
  • Phone: 805-346-8427
  • Fax:
Mailing address:
  • Phone: 805-681-5461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberPHN# 39342
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN# 337695
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: