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General NPI Number Information
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NPI Number | 1659939155
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Entity Type | Individual
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Provider Name | MATTHEW HELLER
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Gender | Male
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Dates
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Enumeration Date | 05/30/2019
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | MARINE CORPS AIR STATION YUMA BLDG. 645, ROOM 207
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City | YUMA
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State | AZ
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Zip | 85365
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Country | US
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Telephone | 305-697-8329
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Fax |
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Provider Business Mailing Address
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Address Line | MARINE CORPS AIR STATION YUMA BLDG. 645, ROOM 207
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City | YUMA
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State | AZ
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Zip | 85365
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Country | US
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Telephone |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101270519
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License Number State | VA
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