Provider Demographics
NPI:1033876859
Name:PRIMUS, HEATHER (MA, MFT)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:PRIMUS
Suffix:
Gender:F
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9350 WILSHIRE BLVD STE 212
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90212-3204
Mailing Address - Country:US
Mailing Address - Phone:310-271-2275
Mailing Address - Fax:
Practice Address - Street 1:9350 WILSHIRE BLVD
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90212-3214
Practice Address - Country:US
Practice Address - Phone:310-271-2275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-29
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist