Provider Demographics
NPI:1114139995
Name:HOFFMAN, RONNA LINN (MFT)
Entity Type:Individual
Prefix:MRS
First Name:RONNA
Middle Name:LINN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4994 PUESTA DEL SOL ST
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-2512
Mailing Address - Country:US
Mailing Address - Phone:310-457-3523
Mailing Address - Fax:
Practice Address - Street 1:4994 PUESTA DEL SOL ST
Practice Address - Street 2:
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-2512
Practice Address - Country:US
Practice Address - Phone:310-457-3523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 30385106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist