Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103G00000X | Clinical Psychologist | ||
N | 103TC0700X | Clinical Psychologist | ||
N | 103G00000X | Clinical Psychologist | PSY8428 | CA |
N | 103TC0700X | Clinical Psychologist | PSY8428 | CA |
Y | 103TF0200X | Forensic Psychologist | ||
N | 103TH0100X | Health Service | ||
N | 103TR0400X | Rehabilitation Psychologist |
NPI | 1356581698 |
---|---|
Provider Name | Dr. Mark Hoffman |
First Address | Represa, CA 95671-3000 |
Second Address | Represa, CA 95671-3000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/02/2009 |
Last Update Date | 26/02/2009 |