Provider Demographics
NPI:1811913510
Name:BARTU, ALLEN S (MFT)
Entity type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:S
Last Name:BARTU
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2943 CAMBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95125-4222
Mailing Address - Country:US
Mailing Address - Phone:408-265-6383
Mailing Address - Fax:408-265-6383
Practice Address - Street 1:2943 CAMBRIDGE DR
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95125-4222
Practice Address - Country:US
Practice Address - Phone:408-265-6383
Practice Address - Fax:408-265-6383
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC18724106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist