Provider Demographics
NPI:1730374083
Name:FUTTERMAN, DOROTHEA HARDT (PSYD)
Entity type:Individual
Prefix:DR
First Name:DOROTHEA
Middle Name:HARDT
Last Name:FUTTERMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:DORA
Other - Middle Name:
Other - Last Name:FUTTERMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PSYD
Mailing Address - Street 1:648 SAINT JOHN ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-6537
Mailing Address - Country:US
Mailing Address - Phone:925-640-8078
Mailing Address - Fax:925-825-7094
Practice Address - Street 1:11740 DUBLIN BLVD
Practice Address - Street 2:SUITE 206
Practice Address - City:DUBLIN
Practice Address - State:CA
Practice Address - Zip Code:94568-2823
Practice Address - Country:US
Practice Address - Phone:925-640-8078
Practice Address - Fax:925-828-8238
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2009-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program