MEDICARE: STACY RINDT-HOFFMAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1235505322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACY RINDT-HOFFMAN

Provider Business Mailing Address
First Line	:	600 W SANTA ANA BLVD
Second Line	:	STE 510
City	:	SANTA ANA
State	:	CA
Zip	:	92701-4558
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 W SANTA ANA BLVD
Second Line	:	STE 510
City	:	SANTA ANA
State	:	CA
Zip	:	92701-4558
Country	:	US
Telephone Number	:	714-667-5600
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2015
Last Update Date	:	08/12/2015

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