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General NPI Number Information
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NPI Number | 1972810828
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Entity Type | Individual
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Provider Name | HEIDI KRISTEN WELLS MA, LMFT
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Gender | Female
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Dates
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Enumeration Date | 09/13/2010
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Last Update Date | 07/16/2019
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Provider Practice Location Address
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Address Line | 1292 PAGE ST
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City | SAN FRANCISCO
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State | CA
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Zip | 94117-3064
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Country | US
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Telephone | 415-621-2929
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Fax | 415-621-4758
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Provider Business Mailing Address
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Address Line | 16480 HARBOR BLVD STE 200
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-1361
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Country | US
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Telephone | 714-884-4408
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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 | MFC #49085
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License Number State | CA
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