Provider Demographics
NPI:1558914994
Name:NURSE-HOFER, ALLISON (LMFT)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:NURSE-HOFER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:NURSE-HOFER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:933 15TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90403-3176
Mailing Address - Country:US
Mailing Address - Phone:310-205-2655
Mailing Address - Fax:
Practice Address - Street 1:2730 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90403-4743
Practice Address - Country:US
Practice Address - Phone:310-205-2655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA94158106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist