Provider Demographics
NPI:1992475800
Name:GUTHRIE, HEIDI ELIZABETH (LMFT)
Entity type:Individual
Prefix:MRS
First Name:HEIDI
Middle Name:ELIZABETH
Last Name:GUTHRIE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16250 QUARTER HORSE RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92504-9629
Mailing Address - Country:US
Mailing Address - Phone:951-367-5485
Mailing Address - Fax:
Practice Address - Street 1:16250 QUARTER HORSE RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92504-9629
Practice Address - Country:US
Practice Address - Phone:951-367-5485
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-14
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA125632106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist