Provider Demographics
NPI:1811604119
Name:PAMELA TESTI LMFT LLC
Entity type:Organization
Organization Name:PAMELA TESTI LMFT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:
Authorized Official - Last Name:TESTI
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:949-485-0580
Mailing Address - Street 1:PO BOX 900
Mailing Address - Street 2:
Mailing Address - City:HEBER CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84032-0900
Mailing Address - Country:US
Mailing Address - Phone:949-485-0580
Mailing Address - Fax:
Practice Address - Street 1:1992 S CREWS CT
Practice Address - Street 2:
Practice Address - City:HEBER CITY
Practice Address - State:UT
Practice Address - Zip Code:84032-1279
Practice Address - Country:US
Practice Address - Phone:949-485-0580
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-04
Last Update Date:2022-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT564410321002Medicaid