Provider Demographics
NPI:1457874927
Name:HARTMAN, YUKIKO KAWABATA (MS)
Entity Type:Individual
Prefix:
First Name:YUKIKO
Middle Name:KAWABATA
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 VARIAN WAY
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94304-2408
Mailing Address - Country:US
Mailing Address - Phone:206-715-0291
Mailing Address - Fax:
Practice Address - Street 1:415 CAMBRIDGE AVE STE 23
Practice Address - Street 2:
Practice Address - City:PALO ALTO
Practice Address - State:CA
Practice Address - Zip Code:94306-1608
Practice Address - Country:US
Practice Address - Phone:206-715-0291
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-17
Last Update Date:2017-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC3885101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health