| Doctor Name: | DR. JON RANDOLPH HABER |
| NPI Number: | 1053556142 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD |
| License Number: | PSY19219 |
| Business Practice Address: | 795 Willow Rd # Mc151j Menlo Park, CA - 940252539 |
| Business Phone Number: | 6506172755 |
| Business Fax Number: | 6506172755 |
| Mailing Address: | 795 Willow Rd # Mc151j, MENLO PARK |
| State: | CA |
| Postal Code: | 940252539 |
| Phone Number: | 6506172755 |
| Fax Number: | 6506172755 |
| NPI Enumeration Date: | 12/03/2008 |
| NPI Last Update Date: | 12/03/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1744R1102X |
| License Number: | PSY19219 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | Research Study |
| Taxonomy Definition: | |