Provider Demographics
NPI:1760040992
Name:HOFFMAN, KELSEY M
Entity Type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:M
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8875 COSTA VERDE BLVD APT 913
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92122-6662
Mailing Address - Country:US
Mailing Address - Phone:518-312-6441
Mailing Address - Fax:
Practice Address - Street 1:8875 COSTA VERDE BLVD APT 913
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-6662
Practice Address - Country:US
Practice Address - Phone:518-312-6441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist