MEDICARE: MS. HEATHER MAHELIA ALLER-STAMPS LMFT

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	MFC# 45621	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2404	OTHER	CA	SAC COUNTY LPHA #
2	45621	OTHER	CA	MARRIGE AND FAMILY THERAPY LICENSE

General Provider Information

NPI Number	:	1851302905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. HEATHER MAHELIA ALLER-STAMPS LMFT

Provider Business Mailing Address
First Line	:	2412 PROFESSIONAL DR
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-7773
Country	:	US
Telephone Number	:	916-778-6035
Fax Number	:

Provider Business Practice Location Address
First Line	:	2412 PROFESSIONAL DR
Second Line	:
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-7773
Country	:	US
Telephone Number	:	916-778-6035
Fax Number	:

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

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	02/01/2023

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