Individual provider Active NPI

Abbey Elizabeth Homen Heidenreich, LMFT

  • Marriage & Family Therapist
  • Santa Rosa, CA
National Provider Identifier
1922534007
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
125044 Issued in CA
Practice address
101 Wikiup Dr
Santa Rosa, CA 95403-1375
Phone
(707) 338-6541
NPI assigned
May 10, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Mental Health Counselor 101YM0800X 98824 CA
Marriage & Family Therapist 106H00000X 98824 CA
Marriage & Family Therapist 106H00000X 125044 CA Primary

Addresses

Primary practice location

101 Wikiup Dr
Santa Rosa, CA 95403-1375

Mailing address

101 Wikiup Dr
Santa Rosa, CA 95403-1375
Phone (707) 338-6541

Other practice location 1

2275 Arlington Dr
San Leandro, CA 94578
Phone (510) 317-1444

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
98824CAMDMental Health Counselor
125044CAMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1922534007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 WIKIUP DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031375",
            "telephone_number": "707-338-6541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 WIKIUP DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954031375",
            "telephone_number": "707-338-6541"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2275 Arlington Dr",
            "address_purpose": "LOCATION",
            "city": "San Leandro",
            "state": "CA",
            "postal_code": "94578",
            "country_code": "US",
            "telephone_number": "510-317-1444",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEIDENREICH",
        "first_name": "ABBEY",
        "middle_name": "ELIZABETH HOMEN",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-10",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "98824",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "98824",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "125044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2023; 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.