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Abbey Elizabeth Homen Heidenreich

Marriage & Family Therapist

Behavioral Health & Social Service Providers

101 Wikiup Dr, Santa Rosa, CA 95403-1375

PECOS Enrollment

Based on the most recent information from CMS, provider Abbey Elizabeth Homen Heidenreich does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1922534007
Provider Type
Individual
Full Name
Heidenreich, Abbey Elizabeth Homen
Credential
LMFT

Gender
Female
Sole Proprietor
No
Enumeration Date
5/10/2017
Last Updated
1/6/2023

Contact Information

Practice Location

101 Wikiup Dr, Santa Rosa, CA 95403-1375

(707) 338-6541

Unlisted Fax

Mailing Location

101 Wikiup Dr, Santa Rosa, CA 95403-1375

(707) 338-6541

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 106H00000X Primary	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 125044 California
Code 101Y00000X	Description Counselor Behavioral Health & Social Service Providers	License Unlisted Issuer
Code 101YM0800X	Description Counselor Behavioral Health & Social Service Providers	License 98824 California
Code 106H00000X	Description Marriage & Family Therapist Behavioral Health & Social Service Providers	License 98824 California

Abbey Elizabeth Homen Heidenreich

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

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Description

License

Code

Description

License

Code

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