Provider Demographics
NPI:1033481676
Name:HARSHMAN, BRUCE DEWAYNE (PHD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:DEWAYNE
Last Name:HARSHMAN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14724 VENTURA BLVD
Mailing Address - Street 2:SUITE 1100
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91403-3501
Mailing Address - Country:US
Mailing Address - Phone:818-990-9150
Mailing Address - Fax:818-985-1835
Practice Address - Street 1:14724 VENTURA BLVD
Practice Address - Street 2:SUITE 1100
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91403-3501
Practice Address - Country:US
Practice Address - Phone:818-990-9150
Practice Address - Fax:818-985-1835
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-28
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT16888106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist