Provider Demographics
NPI:1114279353
Name:ABELLA, HEATHER D (LPCC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:D
Last Name:ABELLA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1287 DONAX AVE
Mailing Address - Street 2:
Mailing Address - City:IMPERIAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:91932-2309
Mailing Address - Country:US
Mailing Address - Phone:505-440-1726
Mailing Address - Fax:
Practice Address - Street 1:1287 DONAX AVE
Practice Address - Street 2:
Practice Address - City:IMPERIAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:91932-2309
Practice Address - Country:US
Practice Address - Phone:505-440-1726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-12
Last Update Date:2023-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0064041101YM0800X
CALPCC12495101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
1497299788OtherNPI