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Individual

ALAN DOUGLAS HEIDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMFT

Contact information

Practice address
4000 BIRCH ST STE 112, NEWPORT BEACH, CA 92660-2255
(760) 646-4949
Mailing address
4000 BIRCH STREET, SUITE 112, NEWPORT BEACH, CA 92660
(760) 646-4949

Taxonomy

Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
106364
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0
N/A
Enumeration date
07/22/2020
Last updated
07/22/2020
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