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General NPI Number Information
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NPI Number | 1457489452
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Entity Type | Individual
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Provider Name | HARVEY MARK CANTER PH.D.
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Gender | Male
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 625 FAIR OAKS AVE SUITE 300
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-2630
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Country | US
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Telephone | 626-395-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 5423 SYLVIA AVE
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City | TARZANA
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State | CA
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Zip | 91356-3117
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Country | US
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Telephone | 818-996-7472
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PSY16267
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License Number State | CA
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