Provider Demographics
NPI:1629575758
Name:HOFFMAN, KRISTEN LEIGH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KRISTEN
Middle Name:LEIGH
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KRIS
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:524 SOLWAY ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91206-2922
Mailing Address - Country:US
Mailing Address - Phone:949-370-8639
Mailing Address - Fax:818-956-1806
Practice Address - Street 1:3699 WILSHIRE BLVD FL 3
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90010-2718
Practice Address - Country:US
Practice Address - Phone:213-351-4521
Practice Address - Fax:213-351-4515
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-05
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW805591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical