Provider Demographics
NPI:1992125165
Name:HASSLEY, KEVIN HART (CATC III)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:HART
Last Name:HASSLEY
Suffix:
Gender:M
Credentials:CATC III
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6666 OWENS DR
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94588-3334
Mailing Address - Country:US
Mailing Address - Phone:925-201-6232
Mailing Address - Fax:
Practice Address - Street 1:6666 OWENS DR
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94588-3334
Practice Address - Country:US
Practice Address - Phone:925-201-6232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-25
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA140000544101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)