Provider Demographics
NPI:1093114449
Name:HOFFMAN, JOE M III (MFT, RPH)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:M
Last Name:HOFFMAN
Suffix:III
Gender:M
Credentials:MFT, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W 5TH ST
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93030-7105
Mailing Address - Country:US
Mailing Address - Phone:805-483-2115
Mailing Address - Fax:805-483-8585
Practice Address - Street 1:501 MARIN ST STE 113
Practice Address - Street 2:
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91360-4265
Practice Address - Country:US
Practice Address - Phone:805-233-4852
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-21
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36452183500000X
CAMFC 34291106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No183500000XPharmacy Service ProvidersPharmacist