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NPI 1679807465

NPI 1679807465 : JENNIFER LYNN HOFFMAN MFT : GRASS VALLEY, CA

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General NPI Number Information
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    NPI Number           |    1679807465
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    Entity Type          |    Individual 
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    Provider Name        |    JENNIFER LYNN HOFFMAN MFT
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/25/2009
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    Last Update Date     |    03/16/2018
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Provider Practice Location Address
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    Address Line         |    563 BRUNSWICK RD STE 9 
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    City                 |    GRASS VALLEY
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    State                |    CA
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    Zip                  |    95945-9544
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    Country              |    US
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    Telephone            |    530-477-0976
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    Fax                  |    530-274-8866
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Provider Business Mailing Address
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    Address Line         |    10385 ALTA ST 
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    City                 |    GRASS VALLEY
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    State                |    CA
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    Zip                  |    95945-6130
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    106H00000X
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    Taxonomy Name        |    Marriage & Family Therapist
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    License Number       |    MFC44842
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    License Number State |    CA
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