Provider Demographics
NPI:1457173445
Name:HEARTPOINT PSYCHIATRY AND WELLNESS, A PROFESSIONAL NURSING CORPORATION
Entity type:Organization
Organization Name:HEARTPOINT PSYCHIATRY AND WELLNESS, A PROFESSIONAL NURSING CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO, CFO, SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:ROBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:805-704-2145
Mailing Address - Street 1:437 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:LOS OSOS- BAYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:93402
Mailing Address - Country:US
Mailing Address - Phone:805-704-2145
Mailing Address - Fax:
Practice Address - Street 1:1428 PHILLIPS LN.
Practice Address - Street 2:SUITE 203
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93401
Practice Address - Country:US
Practice Address - Phone:805-704-2145
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty