Mark D Breithaupt Phd Inc

LBN: Mark D Breithaupt Phd Inc
Mark D Breithaupt Phd Inc is an health care organization with primary practice located at 1100 Lincoln Ave Ste 394 , San Jose CA 95125. The organization recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Clinical is the primary health care specialty. Mark D Breithaupt Phd Inc can be contacted via phone (408) 320-2747, or through Breithaupt, Mark Douglas via phone (408) 320-2747.

Contact Information

Primary practice address
1100 Lincoln Ave Ste 394 San Jose CA 95125
Phone: (408) 320-2747
Fax: (408) 320-2747
Website:
Map and Directions
Authorized official contact:
Name: Breithaupt, Mark Douglas PHD
Phone: (408) 320-2747

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X PSY499 Hawaii
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 103TA0400X PSY499 Hawaii
Behavioral Health & Social Service Providers / Clinical 103TC0700X PSY499 Hawaii
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X PSY499 Hawaii

Profile Details

NPI number 1902115082
LBN Legal business name Mark D Breithaupt Phd Inc
DBA Doing business as
Authorized official Breithaupt, Mark Douglas PHD
Entity Organization
Organization subpart 1 No
Enumeration date Oct 6th, 2010
Last updated Sep 9th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902115082 NPPES
Hawaii Other HMSA HMSA
Hawaii MEDICAID 03451701 HMSA

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