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General NPI Number Information
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NPI Number | 1780483990
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Entity Type | Individual
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Provider Name | HEIDI DARRAH AMFT
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Gender | Female
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Dates
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Enumeration Date | 03/10/2025
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 905 E 2ND ST APT 112
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City | LOS ANGELES
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State | CA
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Zip | 90012-4323
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Country | US
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Telephone | 424-241-2675
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1014
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City | REDONDO BEACH
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State | CA
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Zip | 90278-0014
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT151374
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License Number State | CA
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