Provider Demographics
NPI:1073968624
Name:HEINLA, CHERYL (LMFT)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:
Last Name:HEINLA
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 OAK PARK BLVD
Mailing Address - Street 2:SUITE 208
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4400
Mailing Address - Country:US
Mailing Address - Phone:925-788-4882
Mailing Address - Fax:
Practice Address - Street 1:1610 OAK PARK BLVD
Practice Address - Street 2:SUITE 208
Practice Address - City:PLEASANT HILL
Practice Address - State:CA
Practice Address - Zip Code:94523-4400
Practice Address - Country:US
Practice Address - Phone:925-788-4882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-02
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90412106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist