Provider Demographics
NPI:1649276940
Name:HOFMANN, VIRGINIA E (MD)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:E
Last Name:HOFMANN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:401 BICENTENNIAL WAY
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95403-2149
Mailing Address - Country:US
Mailing Address - Phone:707-571-3778
Mailing Address - Fax:707-571-3799
Practice Address - Street 1:401 BICENTENNIAL WAY
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-2149
Practice Address - Country:US
Practice Address - Phone:707-571-3778
Practice Address - Fax:707-571-3799
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2011-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT0421272084P0015X, 2084P0800X, 2084P0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry