Provider Demographics
NPI:1619198678
Name:HATTER, MARTA YOLANDA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARTA
Middle Name:YOLANDA
Last Name:HATTER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 VENTURE
Mailing Address - Street 2:SUITE 350
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618
Mailing Address - Country:US
Mailing Address - Phone:949-697-4332
Mailing Address - Fax:949-753-8899
Practice Address - Street 1:6 VENTURE
Practice Address - Street 2:SUITE 350
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-0000
Practice Address - Country:US
Practice Address - Phone:949-697-4332
Practice Address - Fax:949-753-8899
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS175401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical