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1649276940

NPI Code Detail

MEDICARE: VIRGINIA E HOFMANN MD

MEDICARE: VIRGINIA E HOFMANN MD

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	2084P0015X	Psychosomatic Medicine Physician	042127	CT
2	2084P0800X	Psychiatry Physician	042127	CT
3	2084P0802X	Addiction Psychiatry Physician	042127	CT

General Provider Information

NPI Number	:	1649276940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA E HOFMANN MD

Provider Business Mailing Address
First Line	:	401 BICENTENNIAL WAY
Second Line	:	DEPARTMENT OF PSYCHIATRY
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-2149
Country	:	US
Telephone Number	:	707-571-3778
Fax Number	:	707-571-3799

Provider Business Practice Location Address
First Line	:	401 BICENTENNIAL WAY
Second Line	:	DEPARTMENT OF PSYCHIATRY
City	:	SANTA ROSA
State	:	CA
Zip	:	95403-2149
Country	:	US
Telephone Number	:	707-571-3778
Fax Number	:	707-571-3799

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

Provider Enumeration Date	:	06/22/2005
Last Update Date	:	03/23/2011

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Directions to “ VIRGINIA E HOFMANN MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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