Provider Demographics
NPI:1912197856
Name:HOFFMAN, MELINDA ANN (RN)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:ANN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12600 WOODLEY AVE
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-1820
Mailing Address - Country:US
Mailing Address - Phone:818-923-8166
Mailing Address - Fax:
Practice Address - Street 1:12600 WOODLEY AVE
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-1820
Practice Address - Country:US
Practice Address - Phone:818-923-8166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA666856163W00000X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse