Provider Demographics
NPI:1033901699
Name:HOSTLER, HEATHER (PPS, ESA)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:HOSTLER
Suffix:
Gender:F
Credentials:PPS, ESA
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:
Other - Last Name:FEDERMEYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NCSP, MESP
Mailing Address - Street 1:13258 ALLISON RANCH RD
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95949-9404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13258 ALLISON RANCH RD
Practice Address - Street 2:
Practice Address - City:GRASS VALLEY
Practice Address - State:CA
Practice Address - Zip Code:95949-9404
Practice Address - Country:US
Practice Address - Phone:530-559-6650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-20
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool