Provider Demographics
NPI:1417495961
Name:HOFFMAN, RYAN CHARLES (LMFT)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:CHARLES
Last Name:HOFFMAN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 SHATTUCK AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94709-1634
Mailing Address - Country:US
Mailing Address - Phone:510-779-2633
Mailing Address - Fax:
Practice Address - Street 1:1600 SHATTUCK AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94709-1634
Practice Address - Country:US
Practice Address - Phone:510-779-2633
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-04
Last Update Date:2019-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA112339106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist