Individual provider Active NPI

Heather Christine Rousselo

  • Marriage & Family Therapist
  • Valencia, CA
National Provider Identifier
1114041522
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MFC49149 Issued in CA
Practice address
28001 Smyth Dr Ste 104
Valencia, CA 91355-4029
Phone
(661) 212-2997
NPI assigned
Mar 19, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MFC49149 CA Primary

Addresses

Primary practice location

28001 Smyth Dr Ste 104
Valencia, CA 91355-4029

Mailing address

19684 Newhouse St
Santa Clarita, CA 91351-2048
Phone (661) 212-2997

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 2, 2025 through May 2, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
MFC49149CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Safe Space Marriage & Family Counseling Corp CurrentSince Jun 5, 2022 Accepting new patients

Locations

28100 Bouquet Canyon Rd
Ste 201
Santa Clarita, CA 91350
Phone (661) 212-2997

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1114041522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19684 NEWHOUSE ST",
            "city": "SANTA CLARITA",
            "state": "CA",
            "postal_code": "913512048",
            "telephone_number": "661-212-2997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28001 SMYTH DR STE 104",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913554029",
            "telephone_number": "661-212-2997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUSSELO",
        "first_name": "HEATHER",
        "middle_name": "CHRISTINE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "MFC49149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Valencia, CA

Sources for this page

Verify at the official NPI Registry.