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General NPI Number Information
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NPI Number | 1407445448
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Entity Type | Individual
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Provider Name | HEATHER EGENBERGER
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Gender | Female
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Dates
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Enumeration Date | 01/14/2021
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 421 N BROOKHURST ST STE 119
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City | ANAHEIM
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State | CA
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Zip | 92801-5618
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Country | US
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Telephone | 714-361-0898
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Fax |
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Provider Business Mailing Address
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Address Line | 1133 CAMELBACK ST UNIT 7792
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City | NEWPORT BEACH
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State | CA
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Zip | 92658-1237
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Country | US
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Telephone | 949-350-2977
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Fax |
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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 | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number | ABA-IN-10208793
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT-157288
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License Number State | CA
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