Healthcare Provider Details

I. General information

NPI: 1407908999
Provider Name (Legal Business Name): ROBERT RAYMOND HARMAN MFTI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5030 EL CAMINO AVE
CARMICHAEL CA
95608
US

IV. Provider business mailing address

8973 CARLISLE AVE
SACRAMENTO CA
95829
US

V. Phone/Fax

Practice location:
  • Phone: 916-609-4961
  • Fax: 916-609-5160
Mailing address:
  • Phone: 916-681-3934
  • Fax: 916-682-0314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberIMF50154
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: