Provider Demographics
NPI:1851302905
Name:ALLER-STAMPS, HEATHER MAHELIA (LMFT)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:MAHELIA
Last Name:ALLER-STAMPS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:MS
Other - First Name:HEATHER
Other - Middle Name:MAHELIA
Other - Last Name:ALLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:2412 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-7773
Mailing Address - Country:US
Mailing Address - Phone:916-778-6035
Mailing Address - Fax:
Practice Address - Street 1:2412 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-7773
Practice Address - Country:US
Practice Address - Phone:916-778-6035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2023-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAMFC# 45621106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2404OtherSAC COUNTY LPHA #
CA45621OtherMARRIGE AND FAMILY THERAPY LICENSE