Provider Demographics
NPI:1740611912
Name:HANSON, HEATHER (LMFT)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:
Last Name:HANSON
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 1:941 SPRING ST STE 5
Mailing Address - Street 2:
Mailing Address - City:PLACERVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95667-4546
Mailing Address - Country:US
Mailing Address - Phone:562-619-1973
Mailing Address - Fax:530-698-5241
Practice Address - Street 1:941 SPRING ST STE 5
Practice Address - Street 2:
Practice Address - City:PLACERVILLE
Practice Address - State:CA
Practice Address - Zip Code:95667-4546
Practice Address - Country:US
Practice Address - Phone:530-341-8772
Practice Address - Fax:530-698-5241
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA69884106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist