Provider Demographics
NPI:1760585939
Name:HEINRICH, TRICIA ANN (MSW, ASW)
Entity Type:Individual
Prefix:
First Name:TRICIA
Middle Name:ANN
Last Name:HEINRICH
Suffix:
Gender:F
Credentials:MSW, ASW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 WOODSIDE LN E APT 4
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-4325
Mailing Address - Country:US
Mailing Address - Phone:916-924-9847
Mailing Address - Fax:
Practice Address - Street 1:720 WOODSIDE LN E APT 4
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-4325
Practice Address - Country:US
Practice Address - Phone:916-924-9847
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAASW19447101YM0800X
CA34989104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA5882OtherMEDI-CAL