Provider Demographics
NPI:1245440551
Name:HOFFER, MCCARTNEY MARTIN
Entity type:Individual
Prefix:
First Name:MCCARTNEY
Middle Name:MARTIN
Last Name:HOFFER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17810 MERRIDY ST APT 212
Mailing Address - Street 2:
Mailing Address - City:NORTHRIDGE
Mailing Address - State:CA
Mailing Address - Zip Code:91325-4693
Mailing Address - Country:US
Mailing Address - Phone:818-349-5364
Mailing Address - Fax:
Practice Address - Street 1:18549 ROSCOE BLVD
Practice Address - Street 2:
Practice Address - City:NORTHRIDGE
Practice Address - State:CA
Practice Address - Zip Code:91324-4632
Practice Address - Country:US
Practice Address - Phone:818-654-3950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor