Provider Demographics
NPI:1043001050
Name:HOFFMAN, LISA MARGARET (PPS)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARGARET
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:PPS
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MARGARET
Other - Last Name:BURKLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PPO
Mailing Address - Street 1:16661 OLD MILL RD
Mailing Address - Street 2:
Mailing Address - City:NEVADA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95959-8675
Mailing Address - Country:US
Mailing Address - Phone:530-265-9052
Mailing Address - Fax:
Practice Address - Street 1:16661 OLD MILL RD
Practice Address - Street 2:
Practice Address - City:NEVADA CITY
Practice Address - State:CA
Practice Address - Zip Code:95959-8675
Practice Address - Country:US
Practice Address - Phone:530-265-9052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-16
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA250014861101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool