Provider Demographics
NPI:1053432369
Name:HOFFMAN, ELIZABETH ANN (MS, RDN)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:ANN
Last Name:HOFFMAN
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:WIBBELMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1308 LUCERNE CT
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93004-2712
Mailing Address - Country:US
Mailing Address - Phone:805-813-1021
Mailing Address - Fax:
Practice Address - Street 1:400 MOBIL AVE STE D9
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-6376
Practice Address - Country:US
Practice Address - Phone:805-738-5700
Practice Address - Fax:805-738-5701
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN721882133V00000X
CA721882133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered