Basic Information
Provider Information
NPI: 1033541008
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: METZ
FirstName: HEATHER
MiddleName: CLAIRE
NamePrefix:  
NameSuffix:  
Credential: ACSW
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 684
Address2:  
City: MONTEREY
State: CA
PostalCode: 939420684
CountryCode: US
TelephoneNumber: 6618034527
FaxNumber:  
Practice Location
Address1: 1441 CONSTITUTION BLVD
Address2:  
City: SALINAS
State: CA
PostalCode: 939063100
CountryCode: US
TelephoneNumber: 8317554111
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/01/2013
LastUpdateDate: 12/30/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1041C0700XASW67544CAY Behavioral Health & Social Service ProvidersSocial WorkerClinical

No ID Information.


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