Healthcare Provider Details

I. General information

NPI: 1811208234
Provider Name (Legal Business Name): MS. HEATHER ANN KWARTZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2010
Last Update Date: 06/30/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6666 OWENS DR
PLEASANTON CA
94588-3334
US

IV. Provider business mailing address

5057 HYDE PARK DR
FREMONT CA
94538-3900
US

V. Phone/Fax

Practice location:
  • Phone: 925-201-6229
  • Fax: 925-485-1273
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number63233
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: