Provider Demographics
NPI:1750827564
Name:HARRINGTON, MARK
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:HARRINGTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6475 SIERRA LN
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-2796
Mailing Address - Country:US
Mailing Address - Phone:925-462-2281
Mailing Address - Fax:925-462-0439
Practice Address - Street 1:6475 SIERRA LN
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2796
Practice Address - Country:US
Practice Address - Phone:925-462-2281
Practice Address - Fax:925-462-0439
Is Sole Proprietor?:No
Enumeration Date:2017-01-18
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-16-22655103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst