Heather Tiffany Dougherty, MSN RN PMHNP-BC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

95021374 Issued in CA

Practice address

11770 Bernardo Plaza CT Ste 370
San Diego, CA 92128-2426

Phone

(858) 673-3360

NPI assigned

Apr 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Mark David Levine MD Professional CorporationGroup PAC ID 0143478305, 165 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: heather.dougherty.p1@direct.pcsd.nextgenshare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mark David Levine M.D. Professional Corporation

  • Psychiatry Physician
  • Sacramento, CA
  • NPI 1154697944

  Psychiatric/Mental Health

  Medicare reassignment Care Compare group NPD
• Mark David Levine, MD Burlingame PC

  • Psychiatry Physician
  • San Mateo, CA
  • NPI 1770709263
  NPD

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

{
    "created_epoch": "1650844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656720000000",
    "number": "1033853114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2116 RAYMOND AVE",
            "city": "RAMONA",
            "state": "CA",
            "postal_code": "920653034",
            "telephone_number": "760-703-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11770 BERNARDO PLAZA CT STE 370",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921282426",
            "telephone_number": "858-673-3360"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2116 Raymond Ave",
            "address_purpose": "LOCATION",
            "city": "Ramona",
            "state": "CA",
            "postal_code": "920653034",
            "country_code": "US",
            "telephone_number": "760-703-7380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11878 Avenue Of Industry",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921283423",
            "country_code": "US",
            "telephone_number": "858-487-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "HEATHER",
        "middle_name": "TIFFANY",
        "name_prefix": "Mrs.",
        "credential": "MSN RN PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-25",
        "last_updated": "2022-07-02",
        "certification_date": "2022-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95093407",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95021374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorna Frances Doucette
• Whitney Doucette
• Joshua Ray Dougan
• Brittany Dougherty, DPT
• Colin M. Dougherty, MD
• Jessica Rose Dougherty, M.D.
• Joshua Don Dougherty, PMHNP
• Megan Dougherty, LCSW
• Floyd Arthur Doughty, M.D.
• Marley Doughty

• Psychiatric/Mental Health Nurse Practitioner in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatric/Mental Health Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.