Healthcare Provider Details

I. General information

NPI: 1891581864
Provider Name (Legal Business Name): HEATHER HARRIS MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2025
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

744 52ND ST FL 5
OAKLAND CA
94609-1810
US

IV. Provider business mailing address

3133 TEXAS ST
OAKLAND CA
94602-2830
US

V. Phone/Fax

Practice location:
  • Phone: 510-428-3885
  • Fax:
Mailing address:
  • Phone: 617-710-4661
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code170300000X
TaxonomyGenetic Counselor (M.S.)
License NumberGC000148
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: