Jackie Lynne Hardman

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

634 Pressley St
Santa Rosa, CA 95404-5526

Phone

(707) 573-6955

NPI assigned

Aug 26, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1770950628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11303 SKYLINE RD",
            "city": "FORESTVILLE",
            "state": "CA",
            "postal_code": "954369737",
            "telephone_number": "707-820-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 PRESSLEY ST",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954045526",
            "telephone_number": "707-573-6955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDMAN",
        "first_name": "JACKIE",
        "middle_name": "LYNNE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-08-26",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL",
            "identifier": "1234",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valerie Rogers Hansen
• Thomas Richard Hanson
• Marriah Crystal Harbison
• Michelle Hardeman-Guptill, LMFT. CCHT
• Katherine Hardin, FNP
• Maryann Hardwick
• Leslie Karin Harford, PA-C
• Jordan Denise Hargadon, OT
• Amparo Hargreaves
• Gretchen Ann Harig, D.C.

• Mental Health Counselor in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Mental Health Counselor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.