Provider Demographics
NPI:1275149783
Name:HEFLIN, MORGAN BRITTANY
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:BRITTANY
Last Name:HEFLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5727 CANOGA AVE APT 138
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-6500
Mailing Address - Country:US
Mailing Address - Phone:310-770-1897
Mailing Address - Fax:
Practice Address - Street 1:5727 CANOGA AVE APT 138
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-6500
Practice Address - Country:US
Practice Address - Phone:310-770-1897
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-20
Last Update Date:2020-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 174H00000X
CA683436164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No174H00000XOther Service ProvidersHealth Educator