Provider Demographics
NPI:1720097009
Name:HOFFMAN, DAVID A 'TONY' (PHD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A 'TONY'
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 POTRERO ST STE 55
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95060-2760
Mailing Address - Country:US
Mailing Address - Phone:831-423-4073
Mailing Address - Fax:831-423-6106
Practice Address - Street 1:303 POTRERO ST STE 55
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95060-2760
Practice Address - Country:US
Practice Address - Phone:831-423-4073
Practice Address - Fax:831-423-6106
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY11455103TC2200X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist