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2251 San Diego Ave Ste B150 San Diego CA 92110-2969 | |
| (619) 780-7100 | |
| (619) 780-7009 |
| Full Name | |
|---|---|
| Speciality | Marriage & Family Therapist |
| Location | 2251 San Diego Ave Ste B150, San Diego, California |
| Authorized Official Name and Position | Susan Papini Heemstra (CEO, SOLE OWNER) |
| Authorized Official Contact | 6197807008 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2251 San Diego Ave Ste B150 San Diego CA 92110-2969 Ph: (619) 780-7100 | 2251 San Diego Ave Ste B150 San Diego CA 92110-2969 Ph: (619) 780-7100 |
| NPI Number | 1104390442 |
|---|---|
| Provider Enumeration Date | 01/21/2019 |
| Last Update Date | 05/01/2024 |
| Certification Date | 05/01/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104390442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 106H00000X | Marriage & Family Therapist | (* (Not Available)) | Primary |
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