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NPI Code Detail

MEDICARE: DANIELLE HIESTAND PSYD, LMFT

MEDICARE: DANIELLE HIESTAND PSYD, LMFT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist48529CA

General Provider Information

NPI Number : 1891828315
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE HIESTAND PSYD, LMFT
Provider Business Mailing Address
First Line : PO BOX 600264
Second Line :
City : SAN DIEGO
State : CA
Zip : 92160-0264
Country : US
Telephone Number : 619-352-0514
Fax Number : 855-969-9491
Provider Business Practice Location Address
First Line : 3511 CAMINO DEL RIO S STE 500
Second Line :
City : SAN DIEGO
State : CA
Zip : 92108-4022
Country : US
Telephone Number : 619-352-0514
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/13/2007
Last Update Date : 05/05/2021

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