Provider Information for 1245642214
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ERIN HAENTJENS MA.
Sex: Female
NPI: 1245642214
Last Updated: 2025-02-24
Certification Date: 2025-02-24
Certification Date: 2025-02-24
Details
| Name | Value | ||||||||
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| NPI | 1245642214 | ||||||||
| Enumeration Date | 2014-05-27 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 530077 ATLANTA, GA 30353-0077 United States Phone: 888-588-8995 | Fax: | ||||||||
| Primary Practice Address | 1439 STONEHEDGE DR PLEASANT HILL, CA 94523-1052 United States Phone: 925-705-2276 | Fax: | ||||||||
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