Provider Demographics
NPI:1366031239
Name:HEADING, DONALD JAMES
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:JAMES
Last Name:HEADING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:339 PAJARO ST STE A
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-3400
Mailing Address - Country:US
Mailing Address - Phone:831-800-7530
Mailing Address - Fax:831-855-1935
Practice Address - Street 1:339 PAJARO ST STE A
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-3400
Practice Address - Country:US
Practice Address - Phone:831-800-7530
Practice Address - Fax:831-855-1935
Is Sole Proprietor?:No
Enumeration Date:2021-01-14
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health