Provider Demographics
NPI:1346421831
Name:HARTLEY, EMILY KATONAH (PSYD)
Entity type:Individual
Prefix:DR
First Name:EMILY
Middle Name:KATONAH
Last Name:HARTLEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CAPS 219 NORTH HALL
Mailing Address - Street 2:UNIVERSITY OF CALIFORNIA, DAVIS
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616
Mailing Address - Country:US
Mailing Address - Phone:530-752-0871
Mailing Address - Fax:
Practice Address - Street 1:CAPS 219 NORTH HALL
Practice Address - Street 2:UNIVERSITY OF CALIFORNIA, DAVIS
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616
Practice Address - Country:US
Practice Address - Phone:530-752-0871
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-26
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY 20900103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist