Doctor Name: | MICHAELA CHRISTINE HEINZE |
NPI Number: | 1053363218 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PHD |
License Number: | PSY14757 |
Business Practice Address: | 10333 El Camino Real Atascadero, CA - 934237001 |
Business Phone Number: | 8054682000 |
Business Fax Number: | 8054666011 |
Mailing Address: | 1600 9th Street, Room 205 Mailstop 2-3 SACRAMENTO |
State: | CA |
Postal Code: | 958146414 |
Phone Number: | 9166542431 |
Fax Number: | 9166543186 |
NPI Enumeration Date: | 05/16/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PSY14757 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |