Basic Information
| Provider Information | |||||||||
| NPI: | 1225274152 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAMERSKI | ||||||||
| FirstName: | HEATHER | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | IMFT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11584 RANGE VIEW RD | ||||||||
| Address2: | |||||||||
| City: | MIRA LOMA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917523013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9516857144 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7246 REMMET AVE | ||||||||
| Address2: | |||||||||
| City: | CANOGA PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 913031531 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8182060360 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/23/2008 | ||||||||
| LastUpdateDate: | 10/14/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106H00000X | IMFT 56507 | CA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.