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NPI Code Detail

MEDICARE: LYNDSAY HEITMANN

MEDICARE: LYNDSAY HEITMANN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1083732903
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNDSAY HEITMANN
Provider Business Mailing Address
First Line : 1502 BRENTFORD AVE
Second Line :
City : WESTLAKE VILLAGE
State : CA
Zip : 91361-1503
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1065 E MAIN ST
Second Line :
City : VENTURA
State : CA
Zip : 93001-3027
Country : US
Telephone Number : 805-652-0596
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2007
Last Update Date : 07/08/2007

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Directions to “ LYNDSAY HEITMANN ” Practice Location

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