Provider Demographics
NPI:1013134352
Name:TRAGESSER, HEIDI B (LCSW)
Entity Type:Individual
Prefix:MS
First Name:HEIDI
Middle Name:B
Last Name:TRAGESSER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40880 AVENIDA CALAFIA
Mailing Address - Street 2:
Mailing Address - City:PALM DESERT
Mailing Address - State:CA
Mailing Address - Zip Code:92260-0367
Mailing Address - Country:US
Mailing Address - Phone:760-447-4446
Mailing Address - Fax:760-340-4191
Practice Address - Street 1:40880 AVENIDA CALAFIA
Practice Address - Street 2:
Practice Address - City:PALM DESERT
Practice Address - State:CA
Practice Address - Zip Code:92260-0367
Practice Address - Country:US
Practice Address - Phone:760-447-4446
Practice Address - Fax:760-340-4191
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS171391041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical