Provider Demographics
NPI:1639762131
Name:HOFFMAN, AUDREY ELIZABETH (OTD, OTR/L, COMT-UL)
Entity Type:Individual
Prefix:DR
First Name:AUDREY
Middle Name:ELIZABETH
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:OTD, OTR/L, COMT-UL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:KENTFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94904-2562
Mailing Address - Country:US
Mailing Address - Phone:415-258-9894
Mailing Address - Fax:
Practice Address - Street 1:801 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:KENTFIELD
Practice Address - State:CA
Practice Address - Zip Code:94904-2562
Practice Address - Country:US
Practice Address - Phone:415-258-9894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-16
Last Update Date:2023-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT21425225X00000X
CAOT25666225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty