Provider Demographics
NPI:1790079762
Name:LOEB, HEATHER (LMFT)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:LOEB
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:PADDLEFORD-LOEB
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:95 S SANTA ROSA ST
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93001-3442
Mailing Address - Country:US
Mailing Address - Phone:805-651-9621
Mailing Address - Fax:
Practice Address - Street 1:644 E THOMPSON BLVD
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93001-2829
Practice Address - Country:US
Practice Address - Phone:805-651-9621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA49556106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist