Provider Demographics
NPI:1457696759
Name:HARTMAN, JOSHUA DAVID (LCSW, LAADC)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:DAVID
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:LCSW, LAADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 SKYWAY DR
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-8552
Mailing Address - Country:US
Mailing Address - Phone:805-233-5773
Mailing Address - Fax:
Practice Address - Street 1:333 SKYWAY DR
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-8552
Practice Address - Country:US
Practice Address - Phone:805-233-5773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-28
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARALR10160914101YA0400X
CA711511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)