Provider Demographics
NPI:1760253918
Name:HEART THERAPY CENTER A PSYCHOTHERAPY CORPORATION
Entity Type:Organization
Organization Name:HEART THERAPY CENTER A PSYCHOTHERAPY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ISA
Authorized Official - Middle Name:
Authorized Official - Last Name:RESER
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:831-439-2174
Mailing Address - Street 1:545 OCEAN VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-3363
Mailing Address - Country:US
Mailing Address - Phone:831-831-4392
Mailing Address - Fax:
Practice Address - Street 1:545 OCEAN VIEW AVE
Practice Address - Street 2:
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-3363
Practice Address - Country:US
Practice Address - Phone:831-831-4392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty