Provider Demographics
NPI:1548335565
Name:STOLPER, HEATHER KIRSTEN (LMF # 90035)
Entity type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:KIRSTEN
Last Name:STOLPER
Suffix:
Gender:F
Credentials:LMF # 90035
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W. FOSTER RD.
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93455
Mailing Address - Country:US
Mailing Address - Phone:805-934-6388
Mailing Address - Fax:
Practice Address - Street 1:500 W. FOSTER RD.
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93455
Practice Address - Country:US
Practice Address - Phone:805-934-6388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2019-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA114811106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist