MEDICARE: MS. KRISTEN LEIGH HOFFMAN LCSW

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	1041C0700X	Clinical Social Worker	LCSW80559	CA

General Provider Information

NPI Number	:	1629575758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KRISTEN LEIGH HOFFMAN LCSW

Provider Business Mailing Address
First Line	:	524 SOLWAY ST
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91206-2922
Country	:	US
Telephone Number	:	949-370-8639
Fax Number	:	818-956-1806

Provider Business Practice Location Address
First Line	:	3699 WILSHIRE BLVD FL 3
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-2718
Country	:	US
Telephone Number	:	213-351-4521
Fax Number	:	213-351-4515

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

Provider Enumeration Date	:	04/05/2018
Last Update Date	:	06/16/2018

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