=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760253918
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEART THERAPY CENTER A PSYCHOTHERAPY CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/15/2024
-----------------------------------------------------
Last Update Date | 10/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 545 OCEAN VIEW AVE
-----------------------------------------------------
City | SANTA CRUZ
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95062-3363
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-831-4392
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 545 OCEAN VIEW AVE
-----------------------------------------------------
City | SANTA CRUZ
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95062-3363
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 831-461-5446
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PSYCHOTHERAPIST
-----------------------------------------------------
Name | ISA RESER
-----------------------------------------------------
Credential | LMFT
-----------------------------------------------------
Telephone | 831-461-5446
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 106H00000X
-----------------------------------------------------
Taxonomy Name | Marriage & Family Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------