MEDICARE: HEATHER TEGELER MFT

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
1	106H00000X	Marriage & Family Therapist	91091	CA

General Provider Information

NPI Number	:	1508222977
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER TEGELER MFT

Provider Business Mailing Address
First Line	:	650 5TH ST
Second Line	:	SUITE 309
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94107-1536
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 5TH ST
Second Line	:	SUITE 309
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94107-1536
Country	:	US
Telephone Number	:	870-219-1443
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/14/2016
Last Update Date	:	01/03/2022

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Directions to “ HEATHER TEGELER MFT” Practice Location

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