Provider Demographics
NPI:1013488618
Name:HOFFMANN, MICHAEL GERARD (BSW, CADC-III, ICADC)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:GERARD
Last Name:HOFFMANN
Suffix:
Gender:M
Credentials:BSW, CADC-III, ICADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3810 ROSIN CT
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-1656
Mailing Address - Country:US
Mailing Address - Phone:916-567-4222
Mailing Address - Fax:
Practice Address - Street 1:3810 ROSIN CT STE 170
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-1658
Practice Address - Country:US
Practice Address - Phone:916-567-4222
Practice Address - Fax:916-567-4220
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-08
Last Update Date:2022-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAB001230819101YA0400X, 171M00000X, 101Y00000X
CACI21340119101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1356605505OtherTURNING POINT COMMUNITY PROGRAMS