Provider Demographics
NPI:1740413731
Name:HAARTMAN, SCOTT (MA, LMFT)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:HAARTMAN
Suffix:
Gender:M
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:155 E CAMPBELL AVE
Mailing Address - Street 2:SUITE 117
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-2063
Mailing Address - Country:US
Mailing Address - Phone:408-480-6137
Mailing Address - Fax:
Practice Address - Street 1:155 E CAMPBELL AVE
Practice Address - Street 2:SUITE 117
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-2063
Practice Address - Country:US
Practice Address - Phone:408-480-6137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-25
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA77097106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist