Provider Demographics
NPI:1881174290
Name:HEARTWORK PSYCHOLOGY, A PSYCHOLOGICAL CORPORATION
Entity type:Organization
Organization Name:HEARTWORK PSYCHOLOGY, A PSYCHOLOGICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOOKS
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:530-727-8872
Mailing Address - Street 1:2529 24TH ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-3508
Mailing Address - Country:US
Mailing Address - Phone:530-727-8872
Mailing Address - Fax:
Practice Address - Street 1:2529 24TH ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-3508
Practice Address - Country:US
Practice Address - Phone:530-727-8872
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-15
Last Update Date:2018-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY28749103TC0700X, 103TC2200X, 103TA0400X
CAPSY29389103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1376825604OtherTHROUGH KAISER
CA1992956387OtherLA COUNTY DEPT OF MENTAL HEALTH