Provider Demographics
NPI:1699122143
Name:HEATHER FOSTER, MFT
Entity type:Organization
Organization Name:HEATHER FOSTER, MFT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:MR
Authorized Official - First Name:IAN
Authorized Official - Middle Name:
Authorized Official - Last Name:FOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:619-993-5547
Mailing Address - Street 1:5752 OBERLIN DR
Mailing Address - Street 2:SUITE 225
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-1747
Mailing Address - Country:US
Mailing Address - Phone:619-993-5547
Mailing Address - Fax:760-529-9444
Practice Address - Street 1:5752 OBERLIN DR
Practice Address - Street 2:SUITE 225
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121-1747
Practice Address - Country:US
Practice Address - Phone:619-993-5547
Practice Address - Fax:760-529-9444
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-14
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43778106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty