Provider Demographics
NPI:1164560967
Name:HARPER, DOUGLAS HAYES
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:HAYES
Last Name:HARPER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9801 ARROWROUTE 101B
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730
Mailing Address - Country:US
Mailing Address - Phone:909-981-6166
Mailing Address - Fax:
Practice Address - Street 1:16730 ARROW BLVD
Practice Address - Street 2:
Practice Address - City:FONTANA
Practice Address - State:CA
Practice Address - Zip Code:92335-3802
Practice Address - Country:US
Practice Address - Phone:909-854-4085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator