Waltz, Heather

Waltz, Heather is an individual health care provider with primary practice located at 1210 S Bascom Ave Ste 127 , San Jose CA 95128-3535. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Behavioral Analyst. Behavioral Health & Social Service Providers / Behavioral Analyst is her primary health care specialty. Waltz, Heather can be contacted via phone (855) 223-7123.

Contact Information

Primary practice address
1210 S Bascom Ave Ste 127 San Jose CA 95128-3535
Phone: (855) 223-7123
Fax: (619) 374-7134
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X California
Behavioral Health & Social Service Providers / Behavioral Analyst 103K00000X 1-14-16151 California

Profile Details

NPI number 1780965350
LBN Legal business name Waltz, Heather
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2011
Last updated Jul 21st, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1780965350 NPPES
California Other ZZZ91892Z COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN#
California Other ZZZ92069Z COUNTY OF SANTA CRUZ MEDICARE GROUP PTAN#

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