Individual provider Active NPI

Gianna Flores Heatherly

  • Marriage & Family Therapist
  • Bakersfield, CA
National Provider Identifier
1770926016
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
LMFT113603 Issued in CA
Practice address
110 S Montclair St
Ste 205
Bakersfield, CA 93309-3111
Phone
(661) 237-5569
Fax
(661) 835-6326
NPI assigned
Apr 16, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 113603 CA
Marriage & Family Therapist 106H00000X LMFT113603 CA Primary

Addresses

Primary practice location

110 S Montclair St
Ste 205
Bakersfield, CA 93309-3111

Mailing address

110 S Montclair St
Ste 205
Bakersfield, CA 93309-3111
Phone (661) 237-5569

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

State licenses

LicenseStateTypeSpecialty
LMFT113603CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Octave Behavioral Health PC Past Accepting new patients
Seeds of Change Therapy Center PastSince Aug 25, 2024 Accepting new patients
Bynum Licensed Clinical Social Work Inc. PastSince Aug 25, 2024 Accepting new patients

Organizations & group practices 3

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": "1366070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1770926016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S MONTCLAIR ST",
            "address_2": "STE 205",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933093111",
            "telephone_number": "661-237-5569",
            "fax_number": "661-835-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S MONTCLAIR ST",
            "address_2": "STE 205",
            "city": "BAKERSFIELD",
            "state": "CA",
            "postal_code": "933093111",
            "telephone_number": "661-237-5569",
            "fax_number": "661-835-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEATHERLY",
        "first_name": "GIANNA",
        "middle_name": "FLORES",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-16",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "113603",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "LMFT113603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bakersfield, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.

Verify at the official NPI Registry.