Healthcare Provider Details

I. General information

NPI: 1922922251
Provider Name (Legal Business Name): CHASE HARTMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

771 SKYLAR LN
PALM SPRINGS CA
92262-0564
US

IV. Provider business mailing address

771 SKYLAR LN
PALM SPRINGS CA
92262-0564
US

V. Phone/Fax

Practice location:
  • Phone: 732-779-3005
  • Fax:
Mailing address:
  • Phone: 732-779-3005
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: