Healthcare Provider Details

I. General information

NPI: 1700105749
Provider Name (Legal Business Name): PAULA S. HEEGAARD M.F.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2010
Last Update Date: 01/04/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2672 BAYSHORE PKWY SUITE 612
MOUNTAIN VIEW CA
94043-1001
US

IV. Provider business mailing address

3781 NATHAN WAY
PALO ALTO CA
94303-4518
US

V. Phone/Fax

Practice location:
  • Phone: 650-855-9690
  • Fax:
Mailing address:
  • Phone: 650-855-9690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMF20103
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: