Provider Demographics
NPI:1033455654
Name:BATESON, HEATHER (LMFT)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:
Last Name:BATESON
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1838 CATALINA CT
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94550-6416
Mailing Address - Country:US
Mailing Address - Phone:925-784-1098
Mailing Address - Fax:
Practice Address - Street 1:1838 CATALINA CT
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94550-6416
Practice Address - Country:US
Practice Address - Phone:925-784-1098
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-31
Last Update Date:2012-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFT31561106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist