Basic Information
Provider Information
NPI: 1962648055
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARMAN
FirstName: DAVID
MiddleName: EUGENE
NamePrefix: DR.
NameSuffix:  
Credential: PSY.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4083 W AVENUE L
Address2: #351
City: QUARTZ HILL
State: CA
PostalCode: 935364202
CountryCode: US
TelephoneNumber: 6617292000
FaxNumber:  
Practice Location
Address1: 44750 60TH ST W
Address2:  
City: LANCASTER
State: CA
PostalCode: 935367619
CountryCode: US
TelephoneNumber: 6617292000
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/19/2008
LastUpdateDate: 03/29/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700XPSY19561CAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


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