Provider Demographics
NPI:1841535713
Name:HEATHER DEMETER, PSYD., INC
Entity type:Organization
Organization Name:HEATHER DEMETER, PSYD., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HEATHER
Authorized Official - Middle Name:
Authorized Official - Last Name:DEMETER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:310-363-0179
Mailing Address - Street 1:300 S BEVERLY DR
Mailing Address - Street 2:SUITE 400
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-4808
Mailing Address - Country:US
Mailing Address - Phone:310-363-0179
Mailing Address - Fax:
Practice Address - Street 1:300 S BEVERLY DR
Practice Address - Street 2:SUITE 400
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-4808
Practice Address - Country:US
Practice Address - Phone:310-363-0179
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21934103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty