Provider Demographics
NPI:1710101506
Name:HEALD, MARGARET (MFT)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:
Last Name:HEALD
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:MARGARET
Other - Middle Name:W
Other - Last Name:LUTTRELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5122 KATELLA AVE
Mailing Address - Street 2:SUITE 305
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2826
Mailing Address - Country:US
Mailing Address - Phone:562-596-2142
Mailing Address - Fax:562-799-6657
Practice Address - Street 1:5122 KATELLA AVE
Practice Address - Street 2:SUITE 305
Practice Address - City:LOS ALAMITOS
Practice Address - State:CA
Practice Address - Zip Code:90720-2826
Practice Address - Country:US
Practice Address - Phone:562-596-2142
Practice Address - Fax:562-799-6657
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34452106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist