Healthcare Provider Details

I. General information

NPI: 1952379844
Provider Name (Legal Business Name): JEANNE SWICKARD HOFFMAN PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 JARRETT WHITE RD TRIPLER ARMY MEDICAL CENTER ATTN:MCHK-PE
TRIPLER AMC HI
96859-5001
US

IV. Provider business mailing address

1 JARRETT WHITE RD TRIPLER ARMY MEDICAL CENTER ATTN:MCHK-PE
TRIPLER AMC HI
96859-5001
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-1817
  • Fax: 808-433-6327
Mailing address:
  • Phone: 808-433-1817
  • Fax: 808-433-6327

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number384
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: