Vianey Canseco Heredia

Individual provider Active NPI Clinical Child & Adolescent Psychologist · Highland, CA

NPI 1376351817 · NPPES record last updated Dec 30, 2024

Key facts

NPI
1376351817
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Child & Adolescent Psychologist 103TC2200X
Practice address
26838 9TH St SPC B8
Highland, CA 92346-3567
Phone
(909) 991-3714
NPI assigned
Dec 30, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X Yes

Addresses

Primary practice location

26838 9TH St SPC B8
Highland, CA 92346-3567

Mailing address

26838 9TH St SPC B8
Highland, CA 92346-3567

Other providers in Highland, CA

All providers in Highland, CA · Clinical Child & Adolescent Psychologist in California

Sources for this page

Verify at the official NPI Registry.