Healthcare Provider Details

I. General information

NPI: 1790612950
Provider Name (Legal Business Name): HEATHER WILLIAMS BAUMGART AMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HEATHER WILLIAMS-BAUMGART AMFT

II. Dates (important events)

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

III. Provider practice location address

925 BROADBECK DR STE 225
NEWBURY PARK CA
91320-1272
US

IV. Provider business mailing address

925 BROADBECK DR STE 225
NEWBURY PARK CA
91320-1272
US

V. Phone/Fax

Practice location:
  • Phone: 818-208-3478
  • Fax:
Mailing address:
  • Phone: 818-208-3478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number144457
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: