Provider Demographics
NPI:1164764536
Name:HARTMAN, LANA (MED, CL)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:MED, CL
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1862 N EDGEMONT ST APT 3
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-4138
Mailing Address - Country:US
Mailing Address - Phone:928-503-5332
Mailing Address - Fax:
Practice Address - Street 1:8134 VAN NUYS BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402-4801
Practice Address - Country:US
Practice Address - Phone:818-908-3820
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-22
Last Update Date:2013-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health