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General NPI Number Information
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NPI Number | 1215149240
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Entity Type | Individual
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Provider Name | ANDREA DURANT HEITZ L.C.S.W.
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Gender | Female
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Dates
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Enumeration Date | 05/03/2007
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Last Update Date | 10/23/2021
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Provider Practice Location Address
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Address Line | 219 N INDIAN HILL BLVD SUITE 101
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City | CLAREMONT
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State | CA
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Zip | 91711-4644
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Country | US
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Telephone | 909-438-4554
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Fax | 909-620-5694
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Provider Business Mailing Address
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Address Line | 5 MONTE DIABLO LN
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City | POMONA
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State | CA
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Zip | 91766-4778
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Country | US
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Telephone | 909-438-4554
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Fax | 909-620-5694
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LCS 22697
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License Number State | CA
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