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General NPI Number Information
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NPI Number | 1205740701
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Entity Type | Organization
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Legal Business Name | HEARTFELT MIND MARRIAGE AND FAMILY THERAPY INC.
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Dates
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Enumeration Date | 09/30/2026
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Last Update Date | 09/30/2026
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Provider Practice Location Address
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Address Line | 1639 11TH ST STE 218
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City | SANTA MONICA
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State | CA
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Zip | 90404-3727
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Country | US
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Telephone | 970-274-3345
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Fax |
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Provider Business Mailing Address
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Address Line | 1639 11TH ST STE 218
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City | SANTA MONICA
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State | CA
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Zip | 90404-3727
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Country | US
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Telephone | 310-844-6335
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Fax |
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Authorized Official
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Title or Position | LMFT/PRESIDENT
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Name | SOPHIA G RODRIGUEZ
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Credential | M.A.
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Telephone | 970-274-3345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State | NULL
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