Provider Demographics
NPI:1730556093
Name:HARDGE, CARLY CHRISTINE RAMIREZ (LMFT)
Entity type:Individual
Prefix:DR
First Name:CARLY
Middle Name:CHRISTINE RAMIREZ
Last Name:HARDGE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:629 3RD AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-5740
Mailing Address - Country:US
Mailing Address - Phone:619-691-1045
Mailing Address - Fax:
Practice Address - Street 1:371 E ST
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-2615
Practice Address - Country:US
Practice Address - Phone:161-969-1104
Practice Address - Fax:619-691-1491
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-21
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT139325106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist