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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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- Elizabeth Cerda Cabrera
- Renee Lee Calderwood
- California Specimen Collection
- Stephen C Cannon
- Marilu Caravez
- Lucy F. Cardona
- Care for Transport LLC
- Andre Carrington
- Casa ABA Behavioral Services LLC
All providers in Highland, CA · Clinical Child & Adolescent Psychologist in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 30, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.