Active NPI
Melissa Ann Hofstetter, PH.D., M.DIV.
- Psychologist
- Pasadena, CA
National Provider Identifier
1093014961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PSY25696
- Practice address
- 595 E Colorado Blvd
Suite 409
Pasadena, CA 91101-2039 - Phone
- (626) 587-4450
- NPI assigned
- Mar 18, 2011
- Last updated
- May 21, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PSY25696 | CA | Primary |
Addresses
Primary practice location
595 E Colorado Blvd
Suite 409
Pasadena, CA 91101-2039
Mailing address
595 E Colorado Blvd
Suite 409
Pasadena, CA 91101-2039
Phone (626) 587-4450
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 10, 2024 through Jan 10, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY25696 | CA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1300406400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369094400000",
"number": "1093014961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "595 E COLORADO BLVD",
"address_2": "SUITE 409",
"city": "PASADENA",
"state": "CA",
"postal_code": "911012039",
"telephone_number": "626-587-4450"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "595 E COLORADO BLVD",
"address_2": "SUITE 409",
"city": "PASADENA",
"state": "CA",
"postal_code": "911012039",
"telephone_number": "626-587-4450"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOFSTETTER",
"first_name": "MELISSA",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "PH.D., M.DIV.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-18",
"last_updated": "2013-05-21",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "CA",
"license": "PSY25696",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pasadena, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.