Healthcare Provider Details

I. General information

NPI: 1568593861
Provider Name (Legal Business Name): STEPHANIE ANNE HEINTZ LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: STEPHANIE ANNE HEINTZ MFT

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 10/02/2024
Certification Date: 10/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 2543
BAKERSFIELD CA
93303-2543
US

IV. Provider business mailing address

PO BOX 2543
BAKERSFIELD CA
93303-2543
US

V. Phone/Fax

Practice location:
  • Phone: 661-238-3120
  • Fax:
Mailing address:
  • Phone: 661-238-3120
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMFC 49877
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: