MEDICARE: BONNIE JEAN HARTMAN MD

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	2084P0800X	Psychiatry Physician	C175390	CA
2	2084P0800X	Psychiatry Physician	MD00034707	WA
3	2084P0804X	Child & Adolescent Psychiatry Physician	C175390	CA

General Provider Information

NPI Number	:	1861470197
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BONNIE JEAN HARTMAN MD

Provider Business Mailing Address
First Line	:	30206 HILLSIDE TER
Second Line	:
City	:	SAN JUAN CAPISTRANO
State	:	CA
Zip	:	92675-1541
Country	:	US
Telephone Number	:	509-859-3478
Fax Number	:

Provider Business Practice Location Address
First Line	:	7224 S RECOVERY RD
Second Line	:
City	:	FRENCH CAMP
State	:	CA
Zip	:	95231-8901
Country	:	US
Telephone Number	:	209-888-6595
Fax Number	:

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

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	02/27/2026

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