Healthcare Provider Details

I. General information

NPI: 1881174290
Provider Name (Legal Business Name): HEARTWORK PSYCHOLOGY, A PSYCHOLOGICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/15/2018
Last Update Date: 08/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2529 24TH ST
SAN FRANCISCO CA
94110-3508
US

IV. Provider business mailing address

2529 24TH ST
SAN FRANCISCO CA
94110-3508
US

V. Phone/Fax

Practice location:
  • Phone: 530-727-8872
  • Fax:
Mailing address:
  • Phone: 530-727-8872
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY28749
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code103TC2200X
TaxonomyClinical Child & Adolescent Psychologist
License NumberPSY28749
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License NumberPSY28749
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License NumberPSY29389
License Number StateCA

VIII. Authorized Official

Name: DR. BARBARA HOOKS
Title or Position: CO-DIRECTOR
Credential: PSYD
Phone: 530-727-8872