Provider Demographics
NPI:1558844977
Name:HOFFMAN, RACHEL L (DNP, PHN, PMHNP-BC)
Entity Type:Individual
Prefix:DR
First Name:RACHEL
Middle Name:L
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:DNP, PHN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 BROCKTON AVENUE, SUITE 511
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-1858
Mailing Address - Country:US
Mailing Address - Phone:909-328-1828
Mailing Address - Fax:909-328-1827
Practice Address - Street 1:1030 E BROCKTON AVE
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-3611
Practice Address - Country:US
Practice Address - Phone:909-328-1830
Practice Address - Fax:909-328-1827
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95010001363LP0808X
CA679977163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse