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NPI Code Detail

MEDICARE: EDIE HARTWICK MFT

MEDICARE: EDIE HARTWICK MFT
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
1106H00000XMarriage & Family TherapistLMFT150965CA

General Provider Information

NPI Number : 1750741468
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDIE HARTWICK MFT
Provider Business Mailing Address
First Line : PO BOX 2182
Second Line :
City : GLENDORA
State : CA
Zip : 91740-2182
Country : US
Telephone Number : 626-885-3315
Fax Number :
Provider Business Practice Location Address
First Line : 95 3RD ST FL 2
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94103-3103
Country : US
Telephone Number : 833-483-3838
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/24/2016
Last Update Date : 03/02/2026

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