Provider Demographics
NPI:1023249703
Name:SCHAEFER, HEATHER ANNE (MFT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNE
Last Name:SCHAEFER
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6529 RIVERSIDE AVE
Mailing Address - Street 2:SUITE 133
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92506-3122
Mailing Address - Country:US
Mailing Address - Phone:951-684-2627
Mailing Address - Fax:951-788-5837
Practice Address - Street 1:6529 RIVERSIDE AVE
Practice Address - Street 2:SUITE 133
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-3122
Practice Address - Country:US
Practice Address - Phone:951-684-2627
Practice Address - Fax:951-788-5837
Is Sole Proprietor?:No
Enumeration Date:2009-07-29
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC 40248106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist