MEDICARE: SAMANTHA L HARI

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor		CA
2	390200000X	Student in an Organized Health Care Education/Training Program		CA

General Provider Information

NPI Number	:	1265082192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAMANTHA L HARI

Provider Business Mailing Address
First Line	:	PO BOX 151240
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92175-1240
Country	:	US
Telephone Number	:	619-278-2400
Fax Number	:

Provider Business Practice Location Address
First Line	:	1255 AMSTERDAM AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10027-5927
Country	:	US
Telephone Number	:	513-787-5010
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2019
Last Update Date	:	09/13/2019

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Directions to “ SAMANTHA L HARI ” Practice Location

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