Jenny Heetderks, Licensed Psychologist, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

JENNY HEETDERKS, LICENSED PSYCHOLOGIST, INC.

Practice address

595 E Colorado Blvd Ste 610
Pasadena, CA 91101-2015

Phone

(626) 765-7668

NPI assigned

Jan 19, 2023

Organization subpart

No

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

Authorized official

Name

Jennifer Heetderks, PSYDNPI 1013177658

Title

Owner

Phone

(626) 765-7668

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Heetderks, PSYD

  • Clinical Psychologist
  • Los Angeles, CA
  • NPI 1013177658
  NPD Authorized official

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

{
    "created_epoch": "1674086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1407561848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1725 WALWORTH AVE",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911042332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 E COLORADO BLVD STE 610",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911012015",
            "telephone_number": "626-765-7668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENNY HEETDERKS, LICENSED PSYCHOLOGIST, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-19",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "HEETDERKS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-765-7668",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Asante James Jenkins
• Fred Jenkins
• Elizabeth Harris Jenks, PH.D.
• Jennifer Walters Family Counseling Inc
• Michael Jennings, AMFT
• Alyssa Jensen
• Lindsay Briana Jensen, AUD
• Sarah Nicole Jensen, MA, CCC-SLP
• Doori Jeong
• Jeffrey Jino Jeong, O.D.

• Clinical Psychologist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Clinical Psychologist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.