Provider Demographics
NPI:1487861100
Name:HARTMAN, DONNA MARIE
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:MARIE
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1777 BOREL PL
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SAN MATEO
Mailing Address - State:CA
Mailing Address - Zip Code:94402-3509
Mailing Address - Country:US
Mailing Address - Phone:650-349-2555
Mailing Address - Fax:650-349-2554
Practice Address - Street 1:1777 BOREL PL
Practice Address - Street 2:SUITE 104
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94402-3509
Practice Address - Country:US
Practice Address - Phone:650-349-2555
Practice Address - Fax:650-349-2554
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC-27921111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor