Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor | IMF77079 | CA |
N | 225C00000X | Rehabilitation Counselor | 77079 | CA |
NPI | 1194271205 |
---|---|
Provider Name | Mrs. Nina Elisa Hoffman |
First Address | Ukiah, CA 95482-2077 |
Second Address | Willits, CA 95490 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2016 |
Last Update Date | 15/08/2018 |