Provider Demographics
NPI:1700675246
Name:HOFFMAN, ALEXIS SIMONE'-TARA (AMFT, APCC)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:SIMONE'-TARA
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:AMFT, APCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 N DUESENBERG DR APT 8108
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:CA
Mailing Address - Zip Code:91764-5938
Mailing Address - Country:US
Mailing Address - Phone:909-294-0656
Mailing Address - Fax:
Practice Address - Street 1:950 N DUESENBERG DR APT 8108
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:CA
Practice Address - Zip Code:91764-5938
Practice Address - Country:US
Practice Address - Phone:909-294-0656
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAPCC19300101YP2500X
CAAMFT154836106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional