Healthcare Provider Details

I. General information

NPI: 1730374083
Provider Name (Legal Business Name): DOROTHEA HARDT FUTTERMAN PSY.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DORA FUTTERMAN PSY.D.

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 11/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11740 DUBLIN BLVD SUITE 206
DUBLIN CA
94568-2823
US

IV. Provider business mailing address

648 SAINT JOHN ST
PLEASANTON CA
94566-6537
US

V. Phone/Fax

Practice location:
  • Phone: 925-640-8078
  • Fax: 925-828-8238
Mailing address:
  • Phone: 925-640-8078
  • Fax: 925-825-7094

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: