Provider Demographics
NPI:1134716129
Name:HASSMAN, KORTNIE NICOLE
Entity type:Individual
Prefix:
First Name:KORTNIE
Middle Name:NICOLE
Last Name:HASSMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KORTNIE
Other - Middle Name:NICOLE
Other - Last Name:FRANCIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:18726 S WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:GARDENA
Mailing Address - State:CA
Mailing Address - Zip Code:90248-3813
Mailing Address - Country:US
Mailing Address - Phone:310-856-0800
Mailing Address - Fax:855-568-2494
Practice Address - Street 1:12015 E 46TH AVE STE 680
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-3158
Practice Address - Country:US
Practice Address - Phone:303-945-7063
Practice Address - Fax:855-568-2494
Is Sole Proprietor?:No
Enumeration Date:2020-12-24
Last Update Date:2020-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst