Provider Demographics
NPI:1760688840
Name:HALPERN, HARRIS STUART (PHD)
Entity Type:Individual
Prefix:
First Name:HARRIS
Middle Name:STUART
Last Name:HALPERN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4727 W 147TH ST APT 201
Mailing Address - Street 2:
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-1307
Mailing Address - Country:US
Mailing Address - Phone:310-263-7173
Mailing Address - Fax:
Practice Address - Street 1:2081 PALOS VERDES DR N
Practice Address - Street 2:
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717-3701
Practice Address - Country:US
Practice Address - Phone:310-517-3486
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY10456103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical