Provider Demographics
NPI:1891831996
Name:HARTER, RETHANA CHIV (MFT)
Entity type:Individual
Prefix:MRS
First Name:RETHANA
Middle Name:CHIV
Last Name:HARTER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1887 MONTEREY HWY
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95112-6192
Mailing Address - Country:US
Mailing Address - Phone:408-494-1561
Mailing Address - Fax:408-292-3640
Practice Address - Street 1:1887 MONTEREY HWY
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95112-6192
Practice Address - Country:US
Practice Address - Phone:408-494-1561
Practice Address - Fax:408-292-3640
Is Sole Proprietor?:No
Enumeration Date:2007-01-29
Last Update Date:2021-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
9999101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health