Active NPI
Heidi Haenisch, PH.D.
- Clinical Psychologist
- Atascadero, CA
National Provider Identifier
1730854001
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 32703
- Practice address
- 10333 El Camino Real
Psychology Department
Atascadero, CA 93422 - Phone
- (805) 468-3573
- NPI assigned
- Aug 10, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 32703 | CA | Primary |
Addresses
Primary practice location
10333 El Camino Real
Psychology Department
Atascadero, CA 93422
Mailing address
10333 El Camino Real
Psychology Department
Atascadero, CA 93422
Phone (805) 468-3573
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628553600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629849600000",
"number": "1730854001",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10333 EL CAMINO REAL",
"address_2": "PSYCHOLOGY DEPARTMENT",
"city": "ATASCADERO",
"state": "CA",
"postal_code": "93422",
"telephone_number": "805-468-3573"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10333 EL CAMINO REAL",
"address_2": "PSYCHOLOGY DEPARTMENT",
"city": "ATASCADERO",
"state": "CA",
"postal_code": "93422",
"telephone_number": "805-468-3573"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAENISCH",
"first_name": "HEIDI",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-08-10",
"last_updated": "2021-08-25",
"certification_date": "2021-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "32703",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atascadero, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.