Individual
HEIDI HAENISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
10333 EL CAMINO REAL, PSYCHOLOGY DEPARTMENT, ATASCADERO, CA 93422
(805) 468-3573
Mailing address
10333 EL CAMINO REAL, PSYCHOLOGY DEPARTMENT, ATASCADERO, CA 93422
(805) 468-3573
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
32703
CA
Other
Enumeration date
08/10/2021
Last updated
08/25/2021
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