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Organization
MINDFUL SPECIALTY ASSOCIATES
Active
Organization
MINDFUL SPECIALTY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT HEINEMEIER (CFO)
(714) 617-0001
Entity
Organization
Contact information
Practice address
24040 CAMINO DEL AVION STE E196, DANA POINT, CA 92629-4005
(714) 617-0001
Mailing address
24040 CAMINO DEL AVION STE E196, DANA POINT, CA 92629-4005
(714) 617-0001
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
2084P0800X
Psychiatry Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/17/2022
Last updated
01/19/2022
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