DR. RANDALL ROY HETTICH (NPI# 1457481244) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457481244 |
| Entity Type | Individual |
| Full Name | DR. RANDALL ROY HETTICH |
| Credential | PH.D., L.M.F.T. |
| Practice Address |
1511 W Garvey Ave N Suite 100 West Covina CA 91790-2138 |
| Mailing Address |
1511 W Garvey Ave N West Covina CA 91790-2138 |
| Practice Telephone | 6268563070 |
| Practice Fax Number | 6268563010 |
| Mailing Telephone | 6268563070 |
| Mailing Fax Number | 6268563010 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-03-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 106H00000X | Marriage & Family Therapist | MFC41087 | CA | Behavioral Health & Social Service Providers |
| Street Address |
1511 W GARVEY AVE N SUITE 100 |
| City | WEST COVINA |
| State | CA |
| Zip Code | 91790-2138 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356729552 | Helen Bashoura | Psychiatry & Neurology | 1511 W Garvey Ave N, West Covina, CA 91790-2138 | 2015-05-08 |
| 1306280581 | Craig Alan Harris | Psychiatry & Neurology | 1511 W Garvey Ave N, West Covina, CA 91790 | 2013-04-18 |
| 1851658850 | Cornell Wells Jr. | Psychiatry & Neurology | 1511 W Garvey Ave N, West Covina, CA 91790-2138 | 2012-04-13 |
| 1710164892 | Yadira Cardenas | Social Worker | 1511 W Garvey Ave N, West Covina, CA 91790-2138 | 2008-01-30 |
| 1649476276 | James Scott Henning | Psychologist | 1511 W Garvey Ave N, West Covina, CA 91790-2138 | 2007-06-21 |
| 1174728943 | Amy C Lee | Counselor | 1511 W Garvey Ave N, West Covina, CA 91790-2138 | 2007-06-20 |
| 1215068754 | Lisa Yajun Chen | Social Worker | 1511 W Garvey Ave N, West Covina, CA 91790-2138 | 2007-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285279067 | Liang-wen Chen | Acupuncturist | 1433 West Merced Ave. Suite 304, West Covina, CA 91790 | 2019-11-15 |
| 1245880517 | Cheuk Man Chan | Acupuncturist | 1433 W Merced Ave., #309, West Covina, CA 91790 | 2019-09-18 |
| 1982174561 | Alexandra Isaacs | Marriage & Family Therapist | 1215 W. West Covina Pkwy., West Covina, CA 91790 | 2018-11-27 |
| 1568949709 | Lulua Zulfikarali Bahrainwala | Student in an Organized Health Care Education/Training Program | 1115 S Sunset Avenue #3940, West Covina, CA 91790 | 2018-07-20 |
| 1417442740 | Lydia Joy David | Nurse Practitioner | 1769 S Sunset Ave, West Covina, CA 91790 | 2018-06-28 |
| 1043721046 | Kimberly E Nevarez | Specialist/Technologist | 410 E Merced Ave Suite D, Suite D, West Covina, CA 91790 | 2017-10-17 |
| 1952825754 | Evan Lee Hendriks | Physician Assistant | 301 S Glendora Ave, Apt 2142, West Covina, CA 91790 | 2017-08-02 |
| 1669994588 | Meryl Francine Liu | Dentist | 1101 S. Glendora Ave #a, West Covina, CA 91790 | 2017-07-12 |
| 1326586330 | Athena Merianos | Marriage & Family Therapist | 1215 W. West Parkway, West Covina, CA 91790 | 2017-02-09 |
| 1912445990 | Lissette Bueno | Case Manager/Care Coordinator | 1517 West Garvey Ave North, West Covina, CA 91790 | 2017-02-09 |
| Find all providers in zip 91790 | ||||
| Taxonomy Code | 106H00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Marriage & Family Therapist |
| A marriage and family therapist is a person with a master's degree in marriage and family therapy, or a master's or doctoral degree in a related mental health field with substantially equivalent coursework in marriage and family therapy, who receives supervised clinical experience, or a person who meets the state requirements to practice as a marriage and family therapist. A marriage and family therapist treats mental and emotional disorders within the context of marriage and family systems. A marriage and family therapist provides mental health and counseling services to individuals, couples, families, and groups. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215407341 | Educational Psychology & Family Counseling Corp | Marriage & Family Therapist | 200 N Grand Ave Apt 258, West Covina, CA 91791-1748 | 2018-12-02 |
| 1982174561 | Alexandra Isaacs | Marriage & Family Therapist | 1215 W. West Covina Pkwy., West Covina, CA 91790 | 2018-11-27 |
| 1093281990 | Through The Sea Marriage and Family Counseling Inc | Marriage & Family Therapist | 1317 W West Covina Pkwy Ste D, West Covina, CA 91790-2800 | 2018-10-17 |
| 1851814073 | Gina Marie Espinoza | Marriage & Family Therapist | 2155 E Garvey Ave N Ste B2, West Covina, CA 91791-1509 | 2017-07-19 |
| 1326586330 | Athena Merianos | Marriage & Family Therapist | 1215 W. West Parkway, West Covina, CA 91790 | 2017-02-09 |
| 1710344577 | Astrid Topete | Marriage & Family Therapist | 1923 E Eckerman Ave, West Covina, CA 91791-1113 | 2016-01-25 |
| 1598199630 | Jazmine Ortiz Ulibarri | Marriage & Family Therapist | 1418 Kauai St, West Covina, CA 91792-1457 | 2013-08-26 |
| 1841542677 | Veronica Gonzalez | Marriage & Family Therapist | 1840 E Thelborn St, 47, West Covina, CA 91791-1451 | 2012-10-03 |
| 1891912424 | Monica Tamayo | Marriage & Family Therapist | 1515 W Cameron Ave, West Covina, CA 91790-2726 | 2007-04-18 |
| 1548385289 | Cynthia Marie Holmes | Marriage & Family Therapist | 1501 W Cameron Ave, Suite 110-5, West Covina, CA 91790-2724 | 2007-03-20 |
| Find all providers in WEST COVINA | ||||
| City | WEST COVINA |
| Zip Code | 91790 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.