Provider Demographics
NPI:1689759631
Name:HARTMAN, TOBY S (MFT)
Entity Type:Individual
Prefix:MISS
First Name:TOBY
Middle Name:S
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4350 PALM AVE
Mailing Address - Street 2:STE 16
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91941-6505
Mailing Address - Country:US
Mailing Address - Phone:619-465-4349
Mailing Address - Fax:619-465-4349
Practice Address - Street 1:4350 PALM AVE
Practice Address - Street 2:STE 16
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-6505
Practice Address - Country:US
Practice Address - Phone:619-465-4349
Practice Address - Fax:619-465-4349
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC38678101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health