Provider Demographics
NPI:1124184718
Name:ZEUG, HEATHER MARTIN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:MARTIN
Last Name:ZEUG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5454 MEADOW VISTA WAY
Mailing Address - Street 2:
Mailing Address - City:AGOURA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91301-1505
Mailing Address - Country:US
Mailing Address - Phone:818-667-6663
Mailing Address - Fax:
Practice Address - Street 1:22231 MULHOLLAND HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:CALABASAS
Practice Address - State:CA
Practice Address - Zip Code:91302-5123
Practice Address - Country:US
Practice Address - Phone:818-667-6663
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA190951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical