Provider Demographics
NPI:1285446161
Name:LISA HOFFORT, PSYD, PSYCHOLOGIST, INC
Entity type:Organization
Organization Name:LISA HOFFORT, PSYD, PSYCHOLOGIST, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOFFORT
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:818-430-3054
Mailing Address - Street 1:11085 HERSHEY ST
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91352-1215
Mailing Address - Country:US
Mailing Address - Phone:818-430-3054
Mailing Address - Fax:
Practice Address - Street 1:572 E GREEN ST STE 304
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2085
Practice Address - Country:US
Practice Address - Phone:818-430-3054
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-27
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health